Potential conflict of interest: None of the authors have any conflicts of interest to disclose.
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
Article first published online: 19 DEC 2013
© 2013 Journal of Gastroenterology and Hepatology Foundation and Wiley Publishing Asia Pty Ltd
Journal of Gastroenterology and Hepatology
Volume 29, Issue 1, pages 74–82, January 2014
How to Cite
Moon, C. M., Park, D. I., Kim, E. R., Kim, Y.-H., Lee, C. K., Lee, S.-H., Kim, J. H., Huh, K.-C., Jung, S.-A., Yoon, S. M., Song, H. J., Jang, H. J., Kim, Y. S., Lee, K.-M. and Shin, J. E. (2014), 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. Journal of Gastroenterology and Hepatology, 29: 74–82. doi: 10.1111/jgh.12369
- Issue published online: 19 DEC 2013
- Article first published online: 19 DEC 2013
- Accepted manuscript online: 23 AUG 2013 06:01AM EST
- Manuscript Accepted: 5 AUG 2013
- biological agent;
- Crohn's disease;
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.
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.
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.
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.