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Clinical Features and Long-term Prognosis of Crohn's Disease in Korea: Results from the Prospective CONNECT Study

Authors
Hong, Seung WookYe, Byong DukCheon, Jae HeeLee, Ji HyunKoo, Ja SeolJang, Byung IkLee, Kang-MoonKim, You SunKim, Tae OhIm, Jong PilSong, Geun AmJung, Sung-AeKim, Hyun SooPark, Dong IlKim, Hyun-SooHuh, Kyu ChanKim, Young-HoCha, Jae MyungSeo, Geom SeogChoi, Chang HwanSong, Hyun JooBaik, Gwang HoKim, Ji WonShin, Sung JaePark, Young SookLee, Chang KyunLee, JunJung, Sung HeeJung, YunhoPark, Sung ChulJoo, Young-EunJeen, Yoon TaeHan, Dong SooYang, Suk-KyunKim, Hyo JongKim, Won HoKim, Joo Sung
Issue Date
Nov-2022
Publisher
거트앤리버 발행위원회
Keywords
Cohort studies; Crohn disease; Prognosis; Multicenter study; Korea
Citation
Gut and Liver, v.16, no.6, pp.907 - 920
Indexed
SCIE
SCOPUS
KCI
Journal Title
Gut and Liver
Volume
16
Number
6
Start Page
907
End Page
920
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2021.sw.kumedicine/55604
DOI
10.5009/gnl210299
ISSN
1976-2283
Abstract
Background/Aims: The prospective Crohn’s Disease Clinical Network and Cohort study is a nationwide multicenter cohort study of patients with Crohn’s disease (CD) in Korea, aiming to prospectively investigate the clinical features and long-term prognosis associated with CD. Methods: Patients diagnosed with CD between January 2009 and September 2019 were prospectively enrolled. They were divided into two cohorts according to the year of diagnosis: cohort 1 (diagnosed between 2009 and 2011) versus cohort 2 (between 2012 and 2019). Results: A total of 1,175 patients were included, and the median follow-up duration was 68 months (interquartile range, 39.0 to 91.0 months). The treatment-free durations for thiopurines (p<0.001) and anti-tumor necrosis factor agents (p=0.018) of cohort 2 were shorter than those of cohort 1. Among 887 patients with B1 behavior at diagnosis, 149 patients (16.8%) progressed to either B2 or B3 behavior during follow-up. Early use of thiopurine was associated with a reduced risk of behavioral progression (adjusted hazard ratio [aHR], 0.69; 95% confidence interval [CI], 0.50 to 0.90), and family history of inflammatory bowel disease was associated with an increased risk of behavioral progression (aHR, 2.29; 95% CI, 1.16 to 4.50). One hundred forty-one patients (12.0%) underwent intestinal resection, and the intestinal resection-free survival time was significantly longer in cohort 2 than in cohort 1 (p=0.003). The early use of thiopurines (aHR, 0.35; 95% CI, 0.23 to 0.51) was independently associated with a reduced risk of intestinal resection. Conclusions: The prognosis of CD in Korea appears to have improved over time, as evidenced by the decreasing intestinal resection rate. Early use of thiopurines was associated with an improved prognosis represented by a reduced risk of intestinal resection.
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Jeen, Yoon Tae
Anam Hospital (Department of Gastroenterology and Hepatology, Anam Hospital)
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