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Early Course of Inflammatory Bowel Disease in a Population-Based Inception Cohort Study From 8 Countries in Asia and Australia.
- Source :
-
Gastroenterology [Gastroenterology] 2016 Jan; Vol. 150 (1), pp. 86-95.e3; quiz e13-4. Date of Electronic Publication: 2015 Sep 15. - Publication Year :
- 2016
-
Abstract
- Background & Aims: The incidence of inflammatory bowel disease (IBD) is increasing in Asia, but little is known about disease progression in this region. The Asia-Pacific Crohn's and Colitis Epidemiology Study was initiated in 2011, enrolling subjects from 8 countries in Asia (China, Hong Kong, Indonesia, Sri Lanka, Macau, Malaysia, Singapore, and Thailand) and Australia. We present data from this ongoing study.<br />Methods: We collected data on 413 patients diagnosed with IBD (222 with ulcerative colitis [UC], 181 with Crohn's disease [CD], 10 with IBD unclassified; median age, 37 y) from 2011 through 2013. We analyzed the disease course and severity and mortality. Risks for medical and surgical therapies were assessed using Kaplan-Meier analysis.<br />Results: The cumulative probability that CD would change from inflammatory to stricturing or penetrating disease was 19.6%. The cumulative probabilities for use of immunosuppressants or anti-tumor necrosis factor agents were 58.9% and 12.0% for patients with CD, and 12.7% and 0.9% for patients with UC, respectively. Perianal CD was associated with an increased risk of anti-tumor necrosis factor therapy within 1 year of its diagnosis (hazard ratio, 2.97; 95% confidence interval, 1.09-8.09). The cumulative probabilities for surgery 1 year after diagnosis were 9.1% for patients with CD and 0.9% for patients with UC. Patients with CD and penetrating disease had a 7-fold increase for risk of surgery, compared with patients with inflammatory disease (hazard ratio, 7.67; 95% confidence interval, 3.93-14.96). The overall mortality for patients with IBD was 0.7%.<br />Conclusions: In a prospective population-based study, we found that the early course of disease in patients with IBD in Asia was comparable with that of the West. Patients with CD frequently progress to complicated disease and have accelerated use of immunosuppressants. Few patients with early stage UC undergo surgery in Asia. Increasing our understanding of IBD progression in different populations can help optimize therapy and improve outcomes.<br /> (Copyright © 2016 AGA Institute. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Adult
Analysis of Variance
Asia epidemiology
Australia epidemiology
Cohort Studies
Colectomy methods
Cross-Sectional Studies
Early Diagnosis
Education, Medical, Continuing
Female
Follow-Up Studies
Humans
Immunosuppressive Agents therapeutic use
Incidence
Inflammatory Bowel Diseases diagnosis
International Cooperation
Male
Middle Aged
Prospective Studies
Risk Assessment
Severity of Illness Index
Survival Rate
Treatment Outcome
Young Adult
Inflammatory Bowel Diseases epidemiology
Inflammatory Bowel Diseases therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1528-0012
- Volume :
- 150
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Gastroenterology
- Publication Type :
- Academic Journal
- Accession number :
- 26385074
- Full Text :
- https://doi.org/10.1053/j.gastro.2015.09.005