P5465 - Clinical Evolution, Complications, and Need for Advanced Therapy in Patients With Ulcerative Colitis: Experience of an Institutional Cohort in Colombia

Gustavo Adolfo Reyes Medina, MD¹, Adriana Margarita Rey Rubiano, MD², José De la Hoz-Valle, MD, MSc(Epi)³, Ivan Camilo Triana, MD², Maria Alejandra Gomez-Gutierrez, MD², Zamira Fernanda Gomez Giraldo, MD³, Juan Diego Castro, ³, Miguel Felipe Cárdenas Mesa, ⁴, Sebastián Dueñas-Hernández, ⁴, Fernando Sierra-Arango, MD, MSc(Epi)²
1Fundación Santa Fe De Bogotá, Bogotá, Cundinamarca, Colombia; 2Fundacion Santa Fe de Bogota, Bogotá, Distrito Capital de Bogota, Colombia; 3Fundación Santa Fe De Bogotá, Bogotá, Distrito Capital de Bogota, Colombia; 4Universidad de los Andes, Bogotá, Distrito Capital de Bogota, Colombia

Introduction: Ulcerative colitis (UC) is a chronic inflammatory disorder with variable clinical trajectories. While disease extension and severity influence outcomes, regional data on complication timing and predictors in Latin America are limited. We aimed to describe the clinical course of UC, focusing on time to major complications and impact of advanced therapies in a Colombian cohort.

Methods: We conducted a retrospective cohort study of 53 adult patients with UC followed at a tertiary care center in Colombia. Demographic, clinical, and therapeutic data were extracted from medical records. Outcomes included intestinal (bleeding, strictures, pseudopolyps, surgery) and extraintestinal complications (osteoporosis, primary sclerosing cholangitis (PSC), uveitis, spondyloarthropathies), timing of onset, and use of immunomodulators or biologics. Statistical comparisons explored associations with sex, disease extent, and treatment refractoriness.

Results: 53 patients were included (39.6% men, 60.4% women). Disease location was proctitis in 38.1%, left-sided colitis in 23.8%, and pancolitis in 30.2%. Intestinal complications occurred in 28.3%, with bleeding requiring hospitalization in 18.9%. Other events included abscesses (5%) and one obstruction; no perforations, megacolon, or fistulas. Extraintestinal manifestations were observed in 15.1%; 5% developed PSC, 7% osteoporosis, and 6% spondyloarthropathies. One patient had uveitis and one thromboembolic disease. No dermatologic manifestations were observed. Surgery was required in 9.4%. Mean time to hemorrhage requiring hospitalization was 51 months. Advanced therapies were started at 46 months. Among refractory patients, vedolizumab was used in 50% and tofacitinib in 33%; only one discontinued due to adverse events. Patients on biologics had fewer intestinal complications (18.8% vs. 30.6%, p=0.2). Female patients had a higher complication rate (34% vs. 19%, p=0.1). All surgical patients had disease extending beyond the rectum. No association was found between timing of biologic initiation and surgery or complications.

Discussion: In this UC cohort, extraintestinal manifestations and need for advanced therapies emerged after several years. While biologics did not significantly alter complication rates, all patients requiring surgery had extensive disease. This study adds real-world evidence from Latin America, an underrepresented region in IBD research, highlighting the need to expand studies in diverse populations to inform context-relevant care.

Disclosures:
Gustavo Adolfo Reyes Medina indicated no relevant financial relationships.
Adriana Margarita Rey Rubiano indicated no relevant financial relationships.
José De la Hoz-Valle indicated no relevant financial relationships.
Ivan Camilo Triana indicated no relevant financial relationships.
Maria Alejandra Gomez-Gutierrez indicated no relevant financial relationships.
Zamira Fernanda Gomez Giraldo indicated no relevant financial relationships.
Juan Diego Castro indicated no relevant financial relationships.
Miguel Felipe Cárdenas Mesa indicated no relevant financial relationships.
Sebastián Dueñas-Hernández indicated no relevant financial relationships.
Fernando Sierra-Arango indicated no relevant financial relationships.

Gustavo Adolfo Reyes Medina, MD¹, Adriana Margarita Rey Rubiano, MD², José De la Hoz-Valle, MD, MSc(Epi)³, Ivan Camilo Triana, MD², Maria Alejandra Gomez-Gutierrez, MD², Zamira Fernanda Gomez Giraldo, MD³, Juan Diego Castro, ³, Miguel Felipe Cárdenas Mesa, ⁴, Sebastián Dueñas-Hernández, ⁴, Fernando Sierra-Arango, MD, MSc(Epi)². P5465 - Clinical Evolution, Complications, and Need for Advanced Therapy in Patients With Ulcerative Colitis: Experience of an Institutional Cohort in Colombia, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.