P1252Phenotypic Progression in Crohn’s Disease: A study of a Puerto Rican Cohort

Background Prevalence of Inflammatory Bowel Disease (IBD), and specifically Crohn’s disease (CD), has increased significantly in Puerto Rico (PR), and is the highest in Latin America. Studies on the behavior of IBD in Hispanics are needed to characterize this ethnic group and better address its healthcare. This study analyzes CD phenotype progression over time in a cohort of Puerto Ricans with CD. Methods Puerto Ricans with all 4 Puerto Rican grandparents were recruited for a USA (NIDDK) IBD genetic study between 2002 and 2012. A questionnaire including demographics, Montreal classification phenotype, clinical and treatment data and blood samples were collected. In 2024, participants were contacted and medical records reviewed to update the questionnaire data. We analyzed progression in phenotype (B1, B2, B3), demographics, family history, surgical interventions, extraintestinal manifestations and therapeutic management. The study is approved by the MSC-IRB. Results A total of 132 subjects aged 24 to 80 years completed the study. The cohort consisted of 60.6% males (n = 80) and 39.4% females (n = 52). At follow-up, the proportion of patients reporting a family history of IBD increased by 21.6% (n = 24). Over a mean of 16 years, 45.4% (n = 62) of patients experienced disease progression. Among those with a B1 phenotype at baseline, 76.7% (n = 46) progressed to B2 or B3, while 46.7% (n = 14) of patients with a B2 phenotype progressed to B3; 54.5% (n = 72) of B1 and B2 phenotypes showed no change. Of those patients with no IBD surgery at recruitment, 62% (n = 44) had one or more interventions at follow-up. Patients who received advanced therapies other than anti-TNF agents had a higher mean increase in surgeries (41.7%, n = 25) compared with those who had not received these therapies (26.4%, n = 19), with a p-value of 0.064. Although this difference was not statistically significant, it suggests a potential marginal association between exposure to non–anti-TNF advanced therapies and subsequent surgical interventions. 70% (n = 42) of patients who received advanced therapies other than anti-TNF had previous anti-TNF exposure, suggesting that they had failed anti-TNF. Conclusion These findings document substantial phenotypic progression and surgical burden in Puerto Ricans with CD despite therapeutic advances. While limited by retrospective design and sample size, this study provides insight into long-term outcomes in a high-risk Hispanic population and supports continued longitudinal investigation. References: 1. Torres EA, Torres-Cintrón M, Velázquez S, Vendrell R, Del Valle A, Pérez CM. Prevalence of inflammatory bowel diseases in Puerto Rico: a health care claims analysis of an insured population. PR Health Sci J. 2021;40(3):103-109. 2. Appleyard CB, Hernández G, Ríos-Bedoya CF. Basic epidemiology of inflammatory bowel disease in Puerto Rico. Inflamm Bowel Dis. 2004;10(2):106-111. doi:10.1097/00054725-200403000-00007 3. Torres EA, Cruz A, Monagas M, et al. Inflammatory bowel disease in Hispanics: the University of Puerto Rico IBD Registry. Int J Inflam. 2012;2012:574079. doi:10.1155/2012/574079 Conflict of interest: Rodriguez Martino, Natalia: No conflict of interest Florez Marques, Serena: No conflict of interest Sanchez Cordero, Milaris: No conflict of interest Cruz Cruz, Jorge: No conflict of interest Torres, Esther A: Institutional research grants from: AbbVie, Genentech-Roche, Sanofi, Prometheus Laboratories