Clinical features and predictors of clinical outcomes in Korean patients with Crohn's disease: A Korean Association for the Study of Intestinal Diseases multicenter study

Chang Mo Moon, Dong Il Park, Eun Ran Kim, Young Ho Kim, Chang Kyun Lee, Suck Ho Lee, Jae Hak Kim, Kyu Chan Huh, Sung Ae Jung, Soon Man Yoon, Hyun Joo Song, Hyun Joo Jang, You Sun Kim, Kang Moon Lee, Jeong Eun Shin

Research output: Contribution to journalArticlepeer-review

31 Scopus citations

Abstract

Background and Aim: Although differences in genetic susceptibility and the clinical features of Crohn's disease (CD) have been reported between Asian and Caucasian patients, the disease course and predictors of CD in Asians remains poorly defined. The study therefore aimed to investigate factors predictive of the clinical outcomes of patients with CD in a Korean population. Methods: This retrospective multicenter cohort study included 728 Korean CD patients from 13 university hospitals. The first CD-related surgery or need for immunosuppressive or biological agents were regarded as the clinical outcomes of interest. Results: A total of 126 (17.3%) CD patients underwent CD-related surgery, while 473 (65.0%) and 196 (26.9%) were prescribed thiopurine drugs and infliximab, respectively. Multivariate Cox regression analysis identified current (hazard ratio [HR]=1.86; P=0.018) and former smoking habits (HR=1.78; P=0.049), stricturing (HR=2.24; P<0.001), and penetrating disease behavior at diagnosis (HR=3.07; P<0.001) as independent predictors associated with the first CD-related surgery. With respect to immunosuppressive and biological agents, younger age (<40 years) (HR=2.17; P<0.001 and HR=2.10; P=0.006, respectively), ileal involvement (HR=1.36; P=0.035 and HR=2.17; P=0.006, respectively), and perianal disease (HR=1.42; P=0.001 and HR=1.38; P=0.038, respectively) at diagnosis were significant predictors for the need of these medications. Conclusions: In Korean patients with CD, stricturing, penetrating disease behavior, and smoking habits at the time of diagnosis are independent predictors for CD-related surgery. It was also identified that younger age (<40 years), ileal involvement, and perianal disease at diagnosis are predictive of a need for immunosuppressive or biological agents.

Original languageEnglish
Pages (from-to)74-82
Number of pages9
JournalJournal of Gastroenterology and Hepatology (Australia)
Volume29
Issue number1
DOIs
StatePublished - Jan 2014

Keywords

  • Biological agent
  • Crohn's disease
  • Immunosuppressant
  • Predictor
  • Surgery

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