DOP63 Time Trends of Environmental and Socio-economical Factors in Patients with Inflammatory Bowel Disease over 40-year of Different Therapeutic Eras; results from a Population-based Cohort from Western Hungarian between 1977-2020, The Hygiene hypothesis revisited

Abstract Background Data from population-based studies investigating the time trends in environmental and socio-economical factors associated with IBD is lacking. We aimed to assess over 40 years of different therapeutic eras patients a prospective inception cohort Veszprem County, Western Hungary. Methods Patients incident were included between January 1,1977 December 31,2020. Environmental factors, including an area living, educational type employment, smoking status, appendectomy, contraceptive drug use, evaluated three based on strategies IBD:cohort-A, 1977-1995 (pre-biologic/pre-immunomodulators era); cohort-B,1996-2008 (immunomodulator cohort-C,2009-2020 (biological era). Results A total 2,240 diagnosed [UC 61.2%, male 51.2%, median age at diagnosis: 35 (IQR 29-49)]. There was significant increase incidence both CD UC1-2. higher proportion active compared UC, rates significantly decreased CD; 60.2%, 49.9%, 38.6% cohorts A, B C (p<0.001). In UC patients, lower stable; 15.4%, 14.5% A,B C, respectively (p=0.981). The use more common than 23.7%,26.6%, 23.7% (p=0.950). appendectomy before diagnosis time; 6.4%, 5.5%, 2.3% (p=0.013). No changes distribution population geographic areas [municipal area: UC; 59.8%/64.8%/62.5% (p=0.309) vs. 62.5%/62.0%/59.0% (p=0.636), A/B/C]. However, fewer percentages who achieved primary school as maximal education level (32.2%,21.9% 11.7% A,B, p <0.001) well less physical work employment (53.4%,51.3%, 42.3% p=0.001) observed CD. (Reference 1.Gonczi L et al. Colitis. 2022 Sep 10:jjac132 Ref 2. Kurti Z Crohns 19:jjac142) Conclusion This one first long-term, 4 decades, employment. this study highlight that association known environmental/socio-economic complex.