Influence of familial forms of inflammatory bowel disease on the use of immunosuppressants, biological agents, and surgery in the era of biological therapies. Results from the ENEIDA project
Authors: González-Muñoza Carlos , Calafat Margalida , Gisbert Javier P , Iglesias Eva , Mínguez Miguel , Sicilia Beatriz , Aceituno Montserrat , Gomollón Fernando , Calvet Xavier , Ricart Elena , De Castro Luisa , Rivero Montserrat , Mesonero Francisco , Márquez Lucía , Nos Pilar , Rodríguez-Pescador Ainhoa , Guardiola Jordi , García-Sepulcre MarianaFe , García-López Santiago , Lorente-Poyatos Rufo H , Alba Cristina , Sánchez-Ocaña Ramon , Vera Isabel , Madero Lucía , Riestra Sabino , Navarro-Llavat Mercedes , Pérez-Calle Jose L , Camps Blau , Van Domselaar Manuel , Lucendo Alfredo J , Martín-Arranz Maria Dolores , Montoro-Huguet Miguel A , Sierra-Ausín Mónica , Llaó Jordina , Carpio Daniel , Varela Pilar , Merino Olga , Fernández-Salazar Luis I , Piqueras Marta , Sesé Eva , Busquets David , Tardillo Carlos , Maroto Nuria , Riera Joan , Martínez-Flores Carlos , Muñoz Fernando , Gordillo-Ábalos Jordi , Bertoletti Federico , Garcia-Planella Esther , Domènech Eugeni ,   the ENEIDA project of GETECCU, González-Muñoza C , Calafat M , Gisbert J P , Iglesias E , Mínguez M , Sicilia B , Aceituno M , Gomollón F , Calvet X , Ricart E , De Castro L , Rivero M , Mesonero F , Márquez L , Nos P , Rodríguez-Pescador A , Guardiola J , García-Sepulcre M F , García-López S , Lorente-Poyatos R H , Alba C , Sánchez-Ocaña R , Vera I , Madero L , Riestra S , Navarro-Llavat M , Pérez-Calle J L , Camps B , Van Domselaar M , Lucendo A J , Martín-Arranz M D , Montoro-Huguet M A , Sierra-Ausín M , Llaó J , Carpio D , Varela P , Merino O , Fernández-Salazar L I , Piqueras M , Sesé E , Busquets D , Tardillo C , Maroto N , Riera J , Martínez-Flores C , Muñoz F , Gordillo-Ábalos J , Bertoletti F , Bermejo F , Vega P , Barreiro-De Acosta M , Ginard D , Huguet J M , Bujanda L , Menacho M , Ponferrada A , Legido J , Fernandez H , Hernandez-Villalba L , Pérez M , Ramírez P , Martínez P , Rodriguez C , Leal C , Pajares R , Novella M T , Almela P , Robledo P , Argüelles F , Alcaín G , Garcia-Planella E , Domènech E 
Published: June 2024

Background and aims

Familial inflammatory bowel disease (IBD) history is a controversial prognostic factor in IBD. We aimed to evaluate the impact of a familial history of IBD on the use of medical and surgical treatments in the biological era.

Methods

Patients included in the prospectively maintained ENEIDA database and diagnosed with IBD after 2005 were included. Familial forms were defined as those cases with at least one first-degree relative diagnosed with IBD. Disease phenotype, the use of biological agents, or surgical treatments were the main outcomes.

Results

A total of 5263 patients [2627 Crohn’s disease (CD); 2636 ulcerative colitis (UC)] were included, with a median follow-up of 31 months. Of these, 507 (10%) corresponded to familial forms. No clinical differences were observed between familial and sporadic IBD forms except a lower age at IBD diagnosis and a higher rate of males in familial forms of UC. In CD, the proportions of patients treated with thiopurines (54.4% vs 46.7%; P = .015) and survival time free of thiopurines (P = .009) were lower in familial forms. No differences were found regarding the use of biological agents. Concerning surgery, a higher rate of intestinal resections was observed in sporadic CD (14.8% vs 9.9%, P = .027). No differences were observed in UC.

Conclusions

In the era of biological therapies, familial and sporadic forms of IBD show similar phenotypes and are managed medically in a similar way; whether these is due to lack of phenotypical differences or an effect of biological therapies is uncertain.

What is already known on this topic: IBD’s etiopathogenesis points to an interaction between environmental and genetic factors, being familial history a controversial prognostic factor. Biological agents use and need for surgery regarding familial or sporadic forms of IBDs present conflicting results. What this study adds: Familial and sporadic forms of IBD have similar phenotypes and are managed medically and surgically in a similar way. How this study might affect research, practice or policy: Familial aggregation should not be considered a factor associated with more aggressive disease.