Rapid diagnosis and therapeutic mitigation in inflammatory bowel disease: utilizing the window of opportunity-findings from the UAE Epi-IBD study.

IF 4.7 Q2 GASTROENTEROLOGY & HEPATOLOGY

Intestinal Research Pub Date : 2026-06-01 DOI:10.5217/ir.2026.00032

Thaer Khaleel Swaid, Layth Raafat Hamzeh, Laurette L Bukasa, Tine Jess, Mohammed Nabil Quraishi

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引用次数: 0

Abstract

Background/aims: To determine time to diagnosis (TTD) and its impact on surgery and advanced therapy (AT) burden in inflammatory bowel disease (IBD) in a multi-ethnic United Arab Emirates (UAE) cohort, a region in the acceleration phase of IBD incidence.

Methods: Retrospective analysis of the UAE Epi-IBD registry. TTD was calculated from patient-reported symptom onset to diagnosis. Logistic, Poisson regression and Cox proportional hazards models were used. Sensitivity analyses using 6- and 18-month thresholds and TTD quartiles were performed.

Results: Among 243 patients (148 Crohn's disease [CD], 95 ulcerative colitis [UC]), median TTD was 4.0 months (interquartile range [IQR], 1.5-9.0 months) for CD and 3.0 months (IQR, 1.0-7.0 months) for UC (P= 0.111, Wilcoxon; log-rank P= 0.054), shorter than pooled estimates from high-income countries. UC TTD accelerated significantly post-2021 (2.0 months vs. 5.5 months; P= 0.006), while CD remained stable (P= 0.646). Diagnostic speed was identical between tertiary and non-tertiary settings (P= 0.943). Diagnostic delay did not predict AT exposure (P= 0.986) or surgical risk (P= 0.586); instead, penetrating CD phenotype drove therapy burden (P= 0.019). Time to first AT was rapid (median 4.5 months for CD, 14.0 months for UC). Era-stratified analysis showed a trend toward higher AT use in 2021 to 2025 (incidence rate ratio, 1.36; 95% CI, 0.98-1.89; P= 0.071), consistent with expanding therapeutic availability, though null association between delay and outcomes persisted after adjustment.

Conclusions: TTD in this cohort is shorter than global benchmarks and comparable to recent Asian data. Diagnostic delay did not predict adverse outcomes, though limited surgical events and short follow-up preclude definitive conclusions. Multiple factors beyond healthcare system architecture may contribute, and larger multicenter studies are needed.

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炎症性肠病的快速诊断和治疗缓解：利用阿联酋Epi-IBD研究的机会之窗

背景/目的：在多民族阿拉伯联合酋长国（UAE）队列中确定炎症性肠病（IBD）的诊断时间（TTD）及其对手术和高级治疗（AT）负担的影响，该地区处于IBD发病率加速阶段。方法：回顾性分析阿联酋Epi-IBD登记。从患者报告的症状开始到诊断为止计算TTD。采用Logistic回归、泊松回归和Cox比例风险模型。采用6个月和18个月阈值和TTD四分位数进行敏感性分析。结果：243例患者中（克罗恩病[CD] 148例，溃疡性结肠炎[UC] 95例），CD的中位TTD为4.0个月（四分位数范围[IQR]， 1.5-9.0个月），UC的中位TTD为3.0个月（IQR, 1.0-7.0个月）（P= 0.111, Wilcoxon; log-rank P= 0.054），短于高收入国家的汇总估计。2021年后，UC TTD明显加速（2.0个月vs 5.5个月，P= 0.006），而CD保持稳定（P= 0.646）。三级和非三级的诊断速度相同（P= 0.943）。诊断延迟不能预测AT暴露（P= 0.986）或手术风险（P= 0.586）；相反，穿透性CD表型驱动治疗负担（P= 0.019）。到第一次AT的时间很快（CD中位4.5个月，UC中位14.0个月）。时代分层分析显示，2021年至2025年AT使用率呈上升趋势（发病率比为1.36；95% CI为0.98-1.89；P= 0.071），这与治疗可用性的扩大一致，尽管调整后延迟和结局之间仍然存在零关联。结论：该队列的TTD短于全球基准，与最近的亚洲数据相当。诊断延迟不能预测不良结果，尽管有限的手术事件和短暂的随访排除了明确的结论。医疗保健系统架构之外的多种因素可能起作用，需要更大规模的多中心研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Intestinal Research GASTROENTEROLOGY & HEPATOLOGY-

CiteScore

7.40

自引率

10.20%

发文量

审稿时长

38 weeks

期刊介绍： Intestinal Research (Intest Res) is the joint official publication of the Asian Organization for Crohn''s and Colitis (AOCC), Chinese Society of IBD (CSIBD), Japanese Society for IBD (JSIBD), Korean Association for the Study of Intestinal Diseases (KASID), Taiwan Society of IBD (TSIBD) and Colitis Crohn''s Foundation (India) (CCF, india). The aim of the Journal is to provide broad and in-depth analysis of intestinal diseases, especially inflammatory bowel disease, which shows increasing tendency and significance. As a Journal specialized in clinical and translational research in gastroenterology, it encompasses multiple aspects of diseases originated from the small and large intestines. The Journal also seeks to propagate and exchange useful innovations, both in ideas and in practice, within the research community. As a mode of scholarly communication, it encourages scientific investigation through the rigorous peer-review system and constitutes a qualified and continual platform for sharing studies of researchers and practitioners. Specifically, the Journal presents up-to-date coverage of medical researches on the physiology, epidemiology, pathophysiology, clinical presentations, and therapeutic interventions of the intestinal diseases. General topics of interest include inflammatory bowel disease, colon and small intestine cancer or polyp, endoscopy, irritable bowel syndrome and other motility disorders, infectious enterocolitis, intestinal tuberculosis, and so forth. The Journal publishes diverse types of academic materials such as editorials, clinical and basic reviews, original articles, case reports, letters to the editor, brief communications, perspective, statement or commentary, and images that are useful to clinicians and researchers.