Temporal Trends and Socio-Demographic Disparities in Inflammatory Bowel Disease: Insights from the Global Burden of Disease Study 2021.

BACKGROUND: Inflammatory bowel disease (IBD) is a chronic immune-mediated gastrointestinal disorder with rising global incidence, especially in industrializing regions. The Global Burden of Disease Study (GBD) framework enables standardized assessment of this growing health challenge. AIMS: To assess temporal trends and socio-demographic disparities in the global burden of IBD from 1990 to 2021 and to project future disease trajectories. METHODS: We obtained data on IBD incidence, mortality, and disability-adjusted life years (DALYs) for 204 countries and territories from 1990 to 2021. Temporal trends were assessed using Joinpoint regression. Future burden from 2022 to 2040 was projected using Bayesian age-period-cohort modeling. Associations with the socio-demographic index (SDI) were examined via Spearman's rank correlation test. Cross-country inequalities in IBD burden were quantified using the slope index of inequality (SII) and concentration index. RESULTS: Between 1990 and 2021, global age-standardized incidence rate (ASIR) of IBD increased [average annual percentage change (AAPC) = 0.16], whereas age-standardized mortality rate (ASMR) (AAPC = - 0.49) and age-standardized DALY rate (ASDR) (AAPC = - 0.57) declined. By 2040, the ASIR, ASMR, and ASDR of IBD are projected to decrease to 4.18, 0.41, and 15.06 per 100,000, respectively. The highest burden was observed in high-SDI regions, particularly Australasia, North America, and Western Europe. From 1990 to 2021, absolute inequalities in IBD incidence (SII: 4.12-6.89) and mortality (SII: 0.35-0.48) widened. CONCLUSION: IBD burden has grown unequally across socio-demographic strata. Despite mortality and DALY reductions, rising incidence and inequalities necessitate targeted prevention and early intervention strategies.