Advanced therapy is delayed in pediatric South Asian inflammatory bowel disease patients in the United States.

OBJECTIVES

South Asian pediatric inflammatory bowel disease (SA pIBD) is a novel at-risk demographic group for pediatric IBD. However, the disease characteristics and treatment strategies for SA pIBD in the United States remain poorly described.

METHODS

In this retrospective cohort study of 147 patients, SA patients with pIBD (n = 55) were matched (~1:2) to non-South Asian (NSA, n = 92) patients with pIBD by age, sex, and disease subtype. Study outcomes included demographics, disease extent and severity, treatments utilized, and patient perspectives on pIBD and its treatment.

RESULTS

Among 55 SA and matched 92 NSA pIBD patients, mean age of presentation was 12 years old, with male predominance (65%), and majority with a Crohn's diagnosis (65%). Very early-onset IBD (VEOIBD) was reported in 5.5% of SA pIBD. SA pIBD patients more frequently presented with weight loss, left-sided disease, upper gastrointestinal manifestations, and elevated erythrocyte sedimentation rate. SA pIBD patients were less likely to use biologic therapies as their initial treatment (9.1% vs. 30.4%, p < 0.005), with a lower cumulative rate of biologic use. Instead, SA pIBD were more likely to use mesalamine or other treatments as their initial therapy.

CONCLUSIONS

SA pIBD had unique phenotypic characteristics compared to NSA pIBD. SA pIBD patients were less likely to initiate biologic therapies as their initial treatment and had a longer time-to-initiation of biologic therapies.