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

Seung Wook Hong, Byong Duk Ye, Jae Hee Cheon, Ji Hyun Lee, Ja Seol Koo, Byung Ik Jang, Kang Moon Lee, You Sun Kim, Tae Oh Kim, Jong Pil Im, Geun Am Song, Sung Ae Jung, Hyun Soo Kim, Dong Il Park, Hyun Soo Kim, Kyu Chan Huh, Young Ho Kim, Jae Myung Cha, Geom Seog Seo, Chang Hwan ChoiHyun Joo Song, Gwang Ho Baik, Ji Won Kim, Sung Jae Shin, Young Sook Park, Chang Kyun Lee, Jun Lee, Sung Hee Jung, Yunho Jung, Sung Chul Park, Young Eun Joo, Yoon Tae Jeen, Dong Soo Han, Suk Kyun Yang, Hyo Jong Kim, Won Ho Kim, Joo Sung Kim

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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.

Original languageEnglish
Pages (from-to)907-920
Number of pages14
JournalGut and liver
Volume16
Issue number6
DOIs
Publication statusPublished - 2022 Nov

Bibliographical note

Publisher Copyright:
© 2022 Editorial Office of Gut and Liver. All rights reserved.

All Science Journal Classification (ASJC) codes

  • Hepatology
  • Gastroenterology

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