Abstract
Abstract Background To characterize the baseline clinical and phenotypic features of patients included in the Kazakhstan IBD Registry in order to establish a foundation for future patient risk stratification and therapy optimization. Methods A consecutive sampling method was applied across secondary and tertiary care centers from all regions of Kazakhstan. Baseline data included demographics, medical history, complications, extraintestinal manifestations, surgical history, and current therapy. Statistical analysis was performed using Jamovi 2.7, with p < 0.05 considered significant. Results From December 2021 to December 2024, 1554 patients were included in the study: 1067 (68.7%) with ulcerative colitis (UC) and 487 (31.3%) with Crohn’s disease (CD). No significant differences were observed between groups in terms of sex or age (median age 42 years [33–55] for UC and 43 years [33–56] for CD, p = 0.482). A positive family history of inflammatory bowel disease (IBD) among first-degree relatives was significantly more common in the CD group (11.1% vs. 6.2%, p < 0.001). Active smoking was also more frequent among CD patients (13.0% vs. 8.8%, p = 0.012). Left-sided colitis (E2, 43.4%) predominated among UC patients, whereas ileocolitis (L3, 45.7%) was most common in CD. Most patients in both groups had active disease at baseline (74.6% in UC and 70.6% in CD; p = 0.104). 5-aminosalicylic acid remained the mainstay therapy for both conditions; mesalazine was prescribed significantly more often in UC (82.0% vs. 73.3%, p < 0.001). Immunosuppressive therapy was used more frequently in CD. Ustekinumab was used significantly more often in Crohn’s disease (13.9% vs. 2.3%, p < 0.001), whereas golimumab was administered exclusively to patients with ulcerative colitis (5.8%, p < 0.001). The majority of patients had no intestinal complications: 96.5% in UC and 92.4% in CD (p < 0.001). Among complications, intestinal obstruction was more characteristic of CD (3.7%), while gastrointestinal bleeding was more typical for UC (2.3%). Conclusion The baseline analysis revealed clear differences between UC and CD, with CD showing a more aggressive course and greater need for advanced therapy, while UC predominantly received 5-ASA. The high rate of active disease likely reflects the involvement of secondary and tertiary care centers, and frequent use of subcutaneous agents reflects their outpatient availability. The registry also revealed gaps in clinical practice requiring improved management. Overall, these findings outline the initial clinical profile and treatment patterns of IBD patients in Kazakhstan. Conflict of interest: Kaibullayeva, Jamilya: No conflict of interest Tanabayeva, Ainash: Ualiyeva, Aliya: No conflict of interest Kabdullina, Nadezhda: No conflict of interest Agzamova, Zukhra: No conflict of interest Gladysheva, Yelena: No conflict of interest Yeskozhina, Ayagoz: No conflict of interest Mussatayev, Issa: No conflict of interest Doszhan, Ainur: No conflict of interest Kurmangaliyeva, Assem: No conflict of interest