Treatment patterns in inflammatory bowel disease in Panama: experience from a specialized center

Abstract

Objective: Inflammatory bowel disease has shown a sustained increase in incidence in developing countries. In Panama, there are no previous reports describing treatment patterns or the use of biologic therapies. The objective is to describe the therapeutic patterns in patients with ulcerative colitis and Crohn's disease, including the use of conventional and advanced therapies, as well as prior exposure to biologic agents in real-world clinical practice. Materials and methods: This was an observational, descriptive, and retrospective study of adult patients with Crohn's disease or ulcerative colitis treated between 2009 and 2024 at a gastroenterology clinic in Panama City. Results: 140 patients were included, with the majority (65%) diagnosed within the last decade. At the time of the last evaluation, 35% were receiving immunomodulators, 33.6% aminosalicylates, 21.4% turmeric and Qing Dai, 7.9% corticosteroids, and 40.7% biologic therapies; 12.1% were not on active treatment. Among patients on biologic therapy, 63.2% were using anti-TNF agents, and 45.6% had received at least one previous biologic. Intestinal surgery was documented in 17.9% of the cohort. Conclusions: High penetration of biological therapies was observed, with significant use of non-anti-TNF agents and the need for multiple lines of treatment in refractory cases. The limited use of aminosalicylates and the pioneering incorporation of turmeric-Qing Dai differentiate this cohort from other Latin American cohorts and reflect the specific characteristics of a specialized private center.