801 Phenotypic Characteristics of Crohn’s Disease in Latin Americans Versus U.S. Hispanics: A Systematic Review with Meta-Analysis

INTRODUCTION: Latin America is experiencing a rise in the prevalence and incidence of inflammatory bowel disease (IBD). Environmental and dietary changes may be contributing factors. In Latin America, Crohn’s disease (CD) is less common than ulcerative colitis (UC), but the predominant phenotype of CD is not established. Also, it is unknown whether there are regional differences in phenotype across Latin America. This systematic review aims to describe the phenotype of CD in Latin Americans as compared with U.S. Hispanics. METHODS: We conducted a systematic review with meta-analysis of population-based studies to compare the phenotype of CD across Latin America with U.S. Hispanics. Phenotype was defined according to the Montreal classification. A systematic search was conducted using MEDLINE and EMBASE. Inclusion criteria: (i) studies describing the phenotype of CD in Latin America and Hispanics in the U.S. (ii) age >18. Exclusion criteria: (i) prevalence or incidence studies not describing the phenotype. A random effects model was chosen “a priori” for analysis of pooled proportions. RESULTS: A total of 4,627 studies were screened. 34 studies from Latin America and 7 studies from the U.S met inclusion criteria. 2,877 Latin Americans and 233 U.S. Hispanics had the diagnosis of CD. The predominant phenotype in Latin America was ileo-colonic disease (L3) with a pooled proportion of 0.37 (95% CI 0.32-0.41, I2 82%), and for U.S. Hispanics, 0.46 (95% CI 0.31-0.61, I2 82.5%), P = 0.88. Inflammatory behavior (B1) was predominant for Latin America and U.S. Hispanics, 0.51 (95% CI 0.41-0.60, I2 94.3%) vs. 0.64 (95% CI 0.42-0.87, I2 91.7%), P = 0.24, respectively. Perianal involvement was similar between Latin Americans and U.S Hispanics with nearly one-third of patients showing this phenotype, P = 0.82. Phenotype across Latin America was similar except in Cuba, where ileal disease was present in nearly one-half of patients. Colonic CD (L2) was less frequently seen in Cuba, 0.15 (95% CI 0.10-0.21), P = 0.002. Disease behavior and perianal involvement were similar across Latin Americans, Table 1. CONCLUSION: The phenotype of Crohn's disease was similar between Latin Americans and U.S. Hispanics. This goes in line with current knowledge that ileo-colonic disease is the predominant disease location in Caucasians. Disease behavior and perianal involvement were similar between Latin Americans and U.S. Hispanics. In Latin America, the phenotype was homogeneous, except in Cuba where ileal disease was the predominant location.