Incidence Rates of IBD Expected to Rise in Germany

The prevalence of inflammatory bowel disease (IBD) is expected to significantly rise among the pediatric population in Germany over the next 8 years.

A team, led by Ivana Kern, Department of Health Sciences/Public Health, Institute and Policlinic for Occupational and Social Medicine, Faculty of Medicine „Carl Gustav Carus”, TU Dresden, investigated the incidence, prevalence, and future trends of IBD in children and adolescent patients in Saxony, Germany.

Increasing Rates of IBD

The rate of IBD is increasingly globally in the pediatric population in recent years.

In the study, the investigators examined data from the Saxon Pediatric IBD Registry on patients aged up to 15 years from 31 pediatric hospitals and pediatric gastroenterologists between 2000-2014.

There was also an independent survey conducted in 2019 with a registry completeness of 95.7%.

The investigators calculated age-standardized incidence rates per 100,000 person-years and the prevalence per 100,000 children and adolescent patients.

Finally, they performed evaluations in sex and age subgroups and conducted Joinpoint and Poisson regression for trend analyses and projections.

IBD Subtypes

Overall, there were 532 patients diagnosed with IBD included in the epidemiological evaluation, 63.5% (n = 338) with Crohn’s disease, 33.1% (n = 176) with ulcerative colitis, and 3.4% (n = 18) with unclassified IBD.

The results show the 15-year prevalence of IBD was 111.8 (95% CI, 102.3-121.3) per 100,000 individuals, while the age-standardized incidence rates per 100,000 person-years over the whole observation period was 7.5 (95% CI, 6.9-8.1).

The investigators also found trends based on the subtype of IBD in the patient.

The age-standardized incidence rates for Crohn’s disease was 4.8 (95% CI, 4.3-5.3), while the age-standardized incidence rate was 2.5 (95% CI, 2.1-2.9) for ulcerative colitis and 0.3 (95% CI, 0.1-0.4) for unclassified IBD.

The results from the joinpoint regression confirmed a significant increase for IBD overall and Crohn’s disease specifically. The age-standardized incidence rate per 100,000 person-yeas increased from 4.6 (95% CI, 2.8-6.3) in 2000 to 8.2 (95% CI, 7.5-13.6) in 2014 for IBD.

The projected incidence rates for IBD are 12.9 (95% CI, 6.5-25.5) in the year 2025 in Germany and 14.9 (95% CI, 6.7-32.8) in 2030.

This means new diagnoses in Germany would increase by 325% in 2030 compared to 2000, with an expected faster increase in Crohn’s disease compared to ulcerative colitis. There would also be more males than females diagnosed with the disease.

For pediatric patients specifically, the number of new diagnoses is expected to increase to approximately 1584 (95% CI, 1512-1655) in 2025 and to about 1918 in 2030.

“The incidence of IBD in children and adolescents in Saxony increased at a similar rate as in other developed countries during the observation period,” the authors wrote. “Given this trend, the health care system must provide adequate resources for the care of these young patients in the future.”

The study, “Current and projected incidence trends of pediatric-onset inflammatory bowel disease in Germany based on the Saxon Pediatric IBD Registry 2000–2014 –a 15-year evaluation of trends,” was published online in PLOS One.