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 Choi; Hyun 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

doi:10.5009/gnl210299

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

Department of Internal Medicine

Research output: Contribution to journal › Article › peer-review

1 Scopus citations

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 language	English
Pages (from-to)	907-920
Number of pages	14
Journal	Gut and Liver
Volume	16
Issue number	6
DOIs	https://doi.org/10.5009/gnl210299
State	Published - Nov 2022

Bibliographical note

Funding Information:
This work was supported by an MSD grant of the Korean Association for the Study of Intestinal Diseases for 2010 and a Research Program funded by the Korea Disease Control and Prevention Agency (2019-ER6905-02).

Funding Information:
B.D.Y. has received a research grant from Celltrion and Pfizer Korea; consulting fees from Abbvie Korea, Celltrion, Chong Kun Dang Pharm., Daewoong Pharma., Ferring Korea, Janssen Korea, Kangstem Biotech, Medtronic Korea, NanoEntek, Pfizer Korea, Shire Korea, Takeda Korea, IQVIA, Cornerstones Health, and Takeda; speaking fees from Abbvie Korea, Celltrion, Ferring Korea, Janssen Korea, Pfizer Korea, Shire Korea, Takeda Korea, and IQVIA. However, all of these are not related to this study. J.H.C., Y.S.K., J.P.I., and J.W.K. are editorial board members of the journal but were not involved in the peer reviewer selection, evaluation, or decision process of this article. No other potential conflicts of interest relevant to this article were reported.

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

Keywords

Cohort studies
Crohn disease
Korea
Multicenter study
Prognosis

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10.5009/gnl210299

Cite this

Hong, S. W., Ye, B. D., Cheon, J. H., Lee, J. H., Koo, J. S., Jang, B. I., Lee, K. M., Kim, Y. S., Kim, T. O., Im, J. P., Song, G. A., Jung, S. A., Kim, H. S., Park, D. I., Kim, H. S., Huh, K. C., Kim, Y. H., Cha, J. M., Seo, G. S., ... Kim, J. S. (2022). Clinical Features and Long-term Prognosis of Crohn's Disease in Korea: Results from the Prospective CONNECT Study. Gut and Liver, 16(6), 907-920. https://doi.org/10.5009/gnl210299

@article{7588a8239f2a4c3eb0850e69132ea5ce,

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

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.",

keywords = "Cohort studies, Crohn disease, Korea, Multicenter study, Prognosis",

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

note = "Funding Information: This work was supported by an MSD grant of the Korean Association for the Study of Intestinal Diseases for 2010 and a Research Program funded by the Korea Disease Control and Prevention Agency (2019-ER6905-02). Funding Information: B.D.Y. has received a research grant from Celltrion and Pfizer Korea; consulting fees from Abbvie Korea, Celltrion, Chong Kun Dang Pharm., Daewoong Pharma., Ferring Korea, Janssen Korea, Kangstem Biotech, Medtronic Korea, NanoEntek, Pfizer Korea, Shire Korea, Takeda Korea, IQVIA, Cornerstones Health, and Takeda; speaking fees from Abbvie Korea, Celltrion, Ferring Korea, Janssen Korea, Pfizer Korea, Shire Korea, Takeda Korea, and IQVIA. However, all of these are not related to this study. J.H.C., Y.S.K., J.P.I., and J.W.K. are editorial board members of the journal but were not involved in the peer reviewer selection, evaluation, or decision process of this article. No other potential conflicts of interest relevant to this article were reported. Publisher Copyright: {\textcopyright} 2022 Editorial Office of Gut and Liver. All rights reserved.",

year = "2022",

month = nov,

doi = "10.5009/gnl210299",

language = "English",

volume = "16",

pages = "907--920",

journal = "Gut and Liver",

issn = "1976-2283",

publisher = "Joe Bok Chung",

number = "6",

}

Hong, SW, Ye, BD, Cheon, JH, Lee, JH, Koo, JS, Jang, BI, Lee, KM, Kim, YS, Kim, TO, Im, JP, Song, GA, Jung, SA, Kim, HS, Park, DI, Kim, HS, Huh, KC, Kim, YH, Cha, JM, Seo, GS, Choi, CH, Song, HJ, Baik, GH, Kim, JW, Shin, SJ, Park, YS, Lee, CK, Lee, J, Jung, SH, Jung, Y, Park, SC, Joo, YE, Jeen, YT, Han, DS, Yang, SK, Kim, HJ, Kim, WH & Kim, JS 2022, 'Clinical Features and Long-term Prognosis of Crohn's Disease in Korea: Results from the Prospective CONNECT Study', Gut and Liver, vol. 16, no. 6, pp. 907-920. https://doi.org/10.5009/gnl210299

TY - JOUR

T1 - Clinical Features and Long-term Prognosis of Crohn's Disease in Korea

T2 - Results from the Prospective CONNECT Study

AU - Hong, Seung Wook

AU - Ye, Byong Duk

AU - Cheon, Jae Hee

AU - Lee, Ji Hyun

AU - Koo, Ja Seol

AU - Jang, Byung Ik

AU - Lee, Kang Moon

AU - Kim, You Sun

AU - Kim, Tae Oh

AU - Im, Jong Pil

AU - Song, Geun Am

AU - Jung, Sung Ae

AU - Kim, Hyun Soo

AU - Park, Dong Il

AU - Kim, Hyun Soo

AU - Huh, Kyu Chan

AU - Kim, Young Ho

AU - Cha, Jae Myung

AU - Seo, Geom Seog

AU - Choi, Chang Hwan

AU - Song, Hyun Joo

AU - Baik, Gwang Ho

AU - Kim, Ji Won

AU - Shin, Sung Jae

AU - Park, Young Sook

AU - Lee, Chang Kyun

AU - Lee, Jun

AU - Jung, Sung Hee

AU - Jung, Yunho

AU - Park, Sung Chul

AU - Joo, Young Eun

AU - Jeen, Yoon Tae

AU - Han, Dong Soo

AU - Yang, Suk Kyun

AU - Kim, Hyo Jong

AU - Kim, Won Ho

AU - Kim, Joo Sung

N1 - Funding Information: This work was supported by an MSD grant of the Korean Association for the Study of Intestinal Diseases for 2010 and a Research Program funded by the Korea Disease Control and Prevention Agency (2019-ER6905-02). Funding Information: B.D.Y. has received a research grant from Celltrion and Pfizer Korea; consulting fees from Abbvie Korea, Celltrion, Chong Kun Dang Pharm., Daewoong Pharma., Ferring Korea, Janssen Korea, Kangstem Biotech, Medtronic Korea, NanoEntek, Pfizer Korea, Shire Korea, Takeda Korea, IQVIA, Cornerstones Health, and Takeda; speaking fees from Abbvie Korea, Celltrion, Ferring Korea, Janssen Korea, Pfizer Korea, Shire Korea, Takeda Korea, and IQVIA. However, all of these are not related to this study. J.H.C., Y.S.K., J.P.I., and J.W.K. are editorial board members of the journal but were not involved in the peer reviewer selection, evaluation, or decision process of this article. No other potential conflicts of interest relevant to this article were reported. Publisher Copyright: © 2022 Editorial Office of Gut and Liver. All rights reserved.

PY - 2022/11

Y1 - 2022/11

N2 - 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.

AB - 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.

KW - Cohort studies

KW - Crohn disease

KW - Korea

KW - Multicenter study

KW - Prognosis

UR - http://www.scopus.com/inward/record.url?scp=85142401079&partnerID=8YFLogxK

U2 - 10.5009/gnl210299

DO - 10.5009/gnl210299

M3 - Article

C2 - 35321956

AN - SCOPUS:85142401079

SN - 1976-2283

VL - 16

SP - 907

EP - 920

JO - Gut and Liver

JF - Gut and Liver

IS - 6

ER -

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

Abstract

Bibliographical note

Keywords

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