Accelerating burden of paediatric IBD in UAE: phenotypes and treatment patterns at a single centre (2012–2024)

Objectives Paediatric-onset inflammatory bowel disease (pIBD) is increasingly prevalent globally, yet data from the United Arab Emirates (UAE) are limited. This study aimed to characterise pIBD epidemiology, clinical presentation, phenotype and treatment at a major UAE tertiary hospital. Methods This retrospective cohort study analysed pIBD patients (<18 years) diagnosed between 2012 and 2024. Data on demographics, phenotype, clinical features and treatment were extracted. Analyses included diagnostic/age trends, temporal phenotype shifts and predictors of biologic failure. Results Of 146 patients (median age 11.0 years; 60.3% male), 58.9% had Crohn’s disease (CD), 34.2% ulcerative colitis (UC) and 6.8% IBD-unclassified. A significant rise in annual pIBD diagnoses was observed (IRR 1.22, p<0.0001), mainly CD (IRR 1.25, p<0.0001). Patients were diagnosed at an older age over time (ρ=0.297, p<0.001). CD was predominantly ileocolonic (68.6%) with frequent perianal (44.2%) and complicated (48.8%) disease. UC was mostly extensive/pancolitis (78.0%). High rates of immunomodulator (CD 83.7%, UC 88.0%) and biologic (CD 76.7%, UC 58.0%) use were noted, with earlier biologic initiation in CD (p=0.001). Lower albumin predicted first biologic failure in CD (p=0.027). Conclusions This study reveals an accelerating pIBD burden in a UAE centre, with CD predominance, complex phenotypes and high advanced therapy use. Findings highlight the growing impact on the paediatric population, necessitating tailored strategies and further research.