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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 
 GUT AND LIVER, Vol.16(6) : 907-920, 2022-11 
Journal Title
Issue Date
Cohort Studies ; Crohn Disease* / diagnosis ; Crohn Disease* / surgery ; Follow-Up Studies ; Humans ; Prognosis ; Prospective Studies ; Retrospective Studies
Cohort studies ; Crohn disease ; Korea ; Multicenter study ; Prognosis
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.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Won Ho(김원호) ORCID logo https://orcid.org/0000-0002-5682-9972
Cheon, Jae Hee(천재희) ORCID logo https://orcid.org/0000-0002-2282-8904
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