Changes in the Long-term Prognosis of Crohn’s Disease between 1986 and 2015: The Population-Based Songpa-Kangdong Inflammatory Bowel Disease Cohort Study

Background/Aims: The long-term course of Crohn’s disease (CD) has never been evaluated in non-Caucasian population-based cohorts. The aim of the present study was to evaluate the longterm prognosis of Korean CD patients in the well-defined population-based Songpa-Kangdong inflammatory bowel disease...

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Published in:Gut and liver 2022-03, Vol.16 (2), p.216
Main Authors: Byong Duk Ye, Sung Noh Hong, Seung In Seo, Ye-Jee Kim, Jae Myung Cha, Kyoung Hoon Rhee, Hyuk Yoon, Young-Ho Kim, Kyung Ho Kim, Sun Yong Park, Seung Kyu Jeong, Ji Hyun Lee, Hyunju Park, Joo Sung Kim, Jong Pil Im, Sung Hoon Kim, Jisun Jang, Jeong Hwan Kim, Seong O Suh, Young Kyun Kim, Sang Hyoung Park, Suk-Kyun Yang
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Language:Korean
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Crohn disease
Korea
Prognosis
SK-IBD
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container_issue 2
container_start_page 216
container_title Gut and liver
container_volume 16
creator Byong Duk Ye
Sung Noh Hong
Seung In Seo
Ye-Jee Kim
Jae Myung Cha
Kyoung Hoon Rhee
Hyuk Yoon
Young-Ho Kim
Kyung Ho Kim
Sun Yong Park
Seung Kyu Jeong
Ji Hyun Lee
Hyunju Park
Joo Sung Kim
Jong Pil Im
Sung Hoon Kim
Jisun Jang
Jeong Hwan Kim
Seong O Suh
Young Kyun Kim
Sang Hyoung Park
Suk-Kyun Yang
description Background/Aims: The long-term course of Crohn’s disease (CD) has never been evaluated in non-Caucasian population-based cohorts. The aim of the present study was to evaluate the longterm prognosis of Korean CD patients in the well-defined population-based Songpa-Kangdong inflammatory bowel disease cohort. Methods: Outcomes of disease and their predictors were evaluated for 418 patients diagnosed with CD between 1986 and 2015. Results: During a median of 123 months, systemic corticosteroids, thiopurines, and anti-tumor necrosis factor (TNF) agents were administered to 58.6%, 81.3%, and 37.1% of patients, respectively. Over time, the cumulative probability of starting corticosteroids significantly decreased (p=0.001), whereas that of starting thiopurines and anti-TNFs significantly increased (both p
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The aim of the present study was to evaluate the longterm prognosis of Korean CD patients in the well-defined population-based Songpa-Kangdong inflammatory bowel disease cohort. Methods: Outcomes of disease and their predictors were evaluated for 418 patients diagnosed with CD between 1986 and 2015. Results: During a median of 123 months, systemic corticosteroids, thiopurines, and anti-tumor necrosis factor (TNF) agents were administered to 58.6%, 81.3%, and 37.1% of patients, respectively. Over time, the cumulative probability of starting corticosteroids significantly decreased (p=0.001), whereas that of starting thiopurines and anti-TNFs significantly increased (both p&lt;0.001). The cumulative probability of behavioral progression was 54.5% at 20 years, and it significantly decreased during the anti-TNF era. Intestinal resection was required for 113 patients (27.0%). The cumulative probabilities of intestinal resection at 1, 5, 10, 20, and 25 years after CD diagnosis were 12.7%, 16.5%, 23.8%, 45.1%, and 51.2%, respectively. Multivariable Cox regression analysis identified stricturing behavior at diagnosis (adjusted hazard ratio [aHR], 2.70; 95% confidence interval [CI], 1.55 to 4.71), penetrating behavior at diagnosis (aHR, 11.15; 95% CI, 6.91 to 17.97), and diagnosis of CD during the anti-TNF era (aHR, 0.51; 95% CI, 0.35 to 0.76) as independently associated with intestinal resection. The standardized mortality ratio among CD patients was 1.36 (95% CI, 0.59 to 2.68). Conclusions: The long-term prognosis of Korean patients with CD is at least as good as that of Western CD patients, as indicated by the low intestinal resection rate. Moreover, behavioral progression and intestinal resection rates have decreased over the past 3 decades. (Gut Liver 2022;16:216-227)</description><identifier>ISSN: 1976-2283</identifier><language>kor</language><publisher>대한소화기기능성질환·운동학회</publisher><subject>Crohn disease ; Korea ; Prognosis ; SK-IBD</subject><ispartof>Gut and liver, 2022-03, Vol.16 (2), p.216</ispartof><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784</link.rule.ids></links><search><creatorcontrib>Byong Duk Ye</creatorcontrib><creatorcontrib>Sung Noh Hong</creatorcontrib><creatorcontrib>Seung In Seo</creatorcontrib><creatorcontrib>Ye-Jee Kim</creatorcontrib><creatorcontrib>Jae Myung Cha</creatorcontrib><creatorcontrib>Kyoung Hoon Rhee</creatorcontrib><creatorcontrib>Hyuk Yoon</creatorcontrib><creatorcontrib>Young-Ho Kim</creatorcontrib><creatorcontrib>Kyung Ho Kim</creatorcontrib><creatorcontrib>Sun Yong Park</creatorcontrib><creatorcontrib>Seung Kyu Jeong</creatorcontrib><creatorcontrib>Ji Hyun Lee</creatorcontrib><creatorcontrib>Hyunju Park</creatorcontrib><creatorcontrib>Joo Sung Kim</creatorcontrib><creatorcontrib>Jong Pil Im</creatorcontrib><creatorcontrib>Sung Hoon Kim</creatorcontrib><creatorcontrib>Jisun Jang</creatorcontrib><creatorcontrib>Jeong Hwan Kim</creatorcontrib><creatorcontrib>Seong O Suh</creatorcontrib><creatorcontrib>Young Kyun Kim</creatorcontrib><creatorcontrib>Sang Hyoung Park</creatorcontrib><creatorcontrib>Suk-Kyun Yang</creatorcontrib><title>Changes in the Long-term Prognosis of Crohn’s Disease between 1986 and 2015: The Population-Based Songpa-Kangdong Inflammatory Bowel Disease Cohort Study</title><title>Gut and liver</title><addtitle>Gut and Liver</addtitle><description>Background/Aims: The long-term course of Crohn’s disease (CD) has never been evaluated in non-Caucasian population-based cohorts. The aim of the present study was to evaluate the longterm prognosis of Korean CD patients in the well-defined population-based Songpa-Kangdong inflammatory bowel disease cohort. Methods: Outcomes of disease and their predictors were evaluated for 418 patients diagnosed with CD between 1986 and 2015. Results: During a median of 123 months, systemic corticosteroids, thiopurines, and anti-tumor necrosis factor (TNF) agents were administered to 58.6%, 81.3%, and 37.1% of patients, respectively. Over time, the cumulative probability of starting corticosteroids significantly decreased (p=0.001), whereas that of starting thiopurines and anti-TNFs significantly increased (both p&lt;0.001). The cumulative probability of behavioral progression was 54.5% at 20 years, and it significantly decreased during the anti-TNF era. Intestinal resection was required for 113 patients (27.0%). The cumulative probabilities of intestinal resection at 1, 5, 10, 20, and 25 years after CD diagnosis were 12.7%, 16.5%, 23.8%, 45.1%, and 51.2%, respectively. Multivariable Cox regression analysis identified stricturing behavior at diagnosis (adjusted hazard ratio [aHR], 2.70; 95% confidence interval [CI], 1.55 to 4.71), penetrating behavior at diagnosis (aHR, 11.15; 95% CI, 6.91 to 17.97), and diagnosis of CD during the anti-TNF era (aHR, 0.51; 95% CI, 0.35 to 0.76) as independently associated with intestinal resection. The standardized mortality ratio among CD patients was 1.36 (95% CI, 0.59 to 2.68). Conclusions: The long-term prognosis of Korean patients with CD is at least as good as that of Western CD patients, as indicated by the low intestinal resection rate. Moreover, behavioral progression and intestinal resection rates have decreased over the past 3 decades. 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The aim of the present study was to evaluate the longterm prognosis of Korean CD patients in the well-defined population-based Songpa-Kangdong inflammatory bowel disease cohort. Methods: Outcomes of disease and their predictors were evaluated for 418 patients diagnosed with CD between 1986 and 2015. Results: During a median of 123 months, systemic corticosteroids, thiopurines, and anti-tumor necrosis factor (TNF) agents were administered to 58.6%, 81.3%, and 37.1% of patients, respectively. Over time, the cumulative probability of starting corticosteroids significantly decreased (p=0.001), whereas that of starting thiopurines and anti-TNFs significantly increased (both p&lt;0.001). The cumulative probability of behavioral progression was 54.5% at 20 years, and it significantly decreased during the anti-TNF era. Intestinal resection was required for 113 patients (27.0%). The cumulative probabilities of intestinal resection at 1, 5, 10, 20, and 25 years after CD diagnosis were 12.7%, 16.5%, 23.8%, 45.1%, and 51.2%, respectively. Multivariable Cox regression analysis identified stricturing behavior at diagnosis (adjusted hazard ratio [aHR], 2.70; 95% confidence interval [CI], 1.55 to 4.71), penetrating behavior at diagnosis (aHR, 11.15; 95% CI, 6.91 to 17.97), and diagnosis of CD during the anti-TNF era (aHR, 0.51; 95% CI, 0.35 to 0.76) as independently associated with intestinal resection. The standardized mortality ratio among CD patients was 1.36 (95% CI, 0.59 to 2.68). Conclusions: The long-term prognosis of Korean patients with CD is at least as good as that of Western CD patients, as indicated by the low intestinal resection rate. Moreover, behavioral progression and intestinal resection rates have decreased over the past 3 decades. (Gut Liver 2022;16:216-227)</abstract><pub>대한소화기기능성질환·운동학회</pub><tpages>12</tpages></addata></record>
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subjects Crohn disease
Korea
Prognosis
SK-IBD
title Changes in the Long-term Prognosis of Crohn’s Disease between 1986 and 2015: The Population-Based Songpa-Kangdong Inflammatory Bowel Disease Cohort Study
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