Long-term evolution of disease behavior of Crohn's disease
Article first published online: 14 DEC 2006
Copyright © 2002 Crohn's & Colitis Foundation of America, Inc.
Inflammatory Bowel Diseases
Volume 8, Issue 4, pages 244–250, July 2002
How to Cite
Cosnes, J., Cattan, S., Blain, A., Beaugerie, L., Carbonnel, F., Parc, R. and Gendre, J.-P. (2002), Long-term evolution of disease behavior of Crohn's disease. Inflamm Bowel Dis, 8: 244–250. doi: 10.1097/00054725-200207000-00002
- Issue published online: 14 DEC 2006
- Article first published online: 14 DEC 2006
- Manuscript Accepted: 1 APR 2002
- Manuscript Received: 25 OCT 2001
- Crohn's disease;
- Intestinal stricture;
- Intestinal perforation;
The Vienna classification of Crohn's disease (CD) distinguishes three patient subgroups according to disease behavior: stricturing, penetrating, and inflammatory. Our aim was to assess the long-term evolution of the disease behavior of CD and to determine the predictive factors and prognostic implications of this evolution.
Occurrence and predictive factors of a stricturing and/or a penetrating complication were searched for in 2,002 patients with CD studied retrospectively. In addition, the 1995–2000 disease course was assessed prospectively in a cohort of 646 patients with disease duration >5 years, classified according to their previous disease behavior.
1,199 patients (60%) developed a stricturing (n = 254) or a penetrating (n = 945) complication. Twenty-year actuarial rates of inflammatory, stricturing, and penetrating disease were 12, 18, and 70%, respectively. The initial location of lesions was the main determinant of the time and type of the complication. In the cohort study, year-by-year activity and therapeutic requirements did not show significant sustained differences between behavioral subgroups.
Most patients with CD will eventually one day develop a stricturing or a perforating complication. Initial location determines the type of the complication. Classification of patients into a behavioral group from previous history has no impact upon activity during the following years.