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Review
. 2020 Jul 9:13:1756284820931739.
doi: 10.1177/1756284820931739. eCollection 2020.

Review of the epidemiology and burden of ulcerative colitis in Latin America

Paulo Gustavo Kotze  1 , Flavio Steinwurz  2 , Carlos Francisconi  3 , Cyrla Zaltman  4 , Marcia Pinheiro  5 , Leonardo Salese  6 , Dario Ponce de Leon  7
Affiliations
Review

Review of the epidemiology and burden of ulcerative colitis in Latin America

Paulo Gustavo Kotze et al. Therap Adv Gastroenterol. .

Abstract

The incidence and prevalence of ulcerative colitis (UC) has been reported to be rising in newly industrialised regions, such as Latin America. Here, we review data from published studies reporting demographics and clinical aspects of UC in Latin America to further understand epidemiology and disease burden. The incidence and prevalence of UC in Latin America varied between regions and studies, ranging between 0.04 to 8.00/100,000 and 0.23 to 76.1/100,000, respectively, and generally increased over the period from 1986 to 2015. The majority of patients with UC were female (53.6-72.6%) and urban residents (77.8-97.4%). Extraintestinal manifestations were reported in approximately 26-89.4% of patients. Use of biologic therapies was generally low (0.8-16.2%), with the exception of Mato Grosso do Sul, Brazil, with a greater proportion of patients tending to receive 5-aminosalicylates, immunosuppressants or corticosteroids; colectomy rates varied between studies (1.5-22%). A high proportion of patients had moderate to severe UC (45.9-73.0%) and, in 11 of 19 studies, the greatest proportion of patients had extensive disease (pancolitis). Colorectal cancer (0-1.7%) and mortality rates (0-7.6%) were low. This evaluation of published studies may influence therapeutic approaches and the development of strategies to improve healthcare access and patient outcomes, although further high-quality studies are required in patients with UC in Latin America.

Keywords: Latin America; disease characteristics; incidence; prevalence; therapies; ulcerative colitis.

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Conflict of interest statement

Conflict of interest statement: P.G. Kotze has received consultancy and speaker fees from AbbVie, Janssen, Pfizer Inc and Takeda; and speaker fees from UCB. F. Steinwurz has been an advisory board member for Pfizer Inc; and has received consultancy and speaker fees from Eurofarma, Janssen, Takeda and UCB. C. Francisconi has been an advisory board member for, and has received clinical investigator support from, Pfizer Inc; and has received clinical investigator support from AbbVie, Celgene, Janssen and Takeda. C. Zaltman has been an advisory board member for Pfizer Inc and UCB; has received speaker fees from AbbVie, Janssen, Takeda and UCB; and has received clinical investigator support from AbbVie, Janssen, Pfizer Inc and Takeda. M. Pinheiro, L. Salese and D. Ponce de Leon are employees and stockholders of Pfizer Inc.

Figures

Figure 1.
Figure 1.
Study selection. aRelevant reviews that were identified are included in the Discussion, not in the Results section of the manuscript.
Figure 2.
Figure 2.
Extent of disease in patients with UC in Latin America. aAlso includes proctosigmoiditis. bDisease extent in one patient was classified as backwash ileitis. UC, ulcerative colitis.
Figure 3.
Figure 3.
Disease severity in Brazilian patients with UC. UC severity was determined in Piauí and Mato Grosso do Sul using the Montreal classification; the method for determining UC severity in Sergipe was not specified. UC, ulcerative colitis.
See this image and copyright information in PMC

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