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P109. Evolution of the disease behavior in pediatric and adult onset CD in a population-based incident cohort from Western Hungary

B.D. Lovasz1, L. Lakatos2, A. Horvath3, T. Pandur2, Z. Erdelyi2, G. Mester4, M. Balogh4, I. Szipocs5, C. Molnar6, E. Komaromi7, P.A. Golovics1, L.S. Kiss8, P. Lakatos1

1Semmelweis University, 1st Department of Medicine, Budapest, Hungary; 2Csolnoky F. Province Hospital, 1st Department of Medicine, Veszprem, Hungary; 3Csolnoky F. Province Hospital, Department of Pediatrics, Veszprem, Hungary; 4Grof Eszterhazy Hospital, Papa, Hungary; 5Municipal Hospital, Tapolca, Hungary; 6Magyar Imre Hospital, Ajka, Hungary; 7Municipal Hospital, Varpalota, Hungary; 8Semmelweis University, Internal Medicine Clinic, Budapest, Hungary

Background: The disease behaviour is changing significantly during the disease course in patients with Crohn's disease. Limited data are available however, if the trends are similar or different in pediatric and adult onset CD populations. Therefore our aim was to analyze the time trends of disease behavior in the population-based Veszprem province database, which included incident patients diagnosed between January 1, 1977 and December 31, 2008 in adult and pediatric onset CD populations.

Methods: Data of 506 incident CD patients were analyzed (median age-at-diagnosis: 31.5 SD 13.8 years). Both in- and outpatient records were collected and comprehensively reviewed.

Results: 74 (14.6%) CD patients were diagnosed <18 years of age. There was no significant difference in the distribution of disease behaviour states between adult and pediatric onset CD patients at diagnosis or during follow-up (Tables 1 and 2, p = NS).

Tables 1 and 2 Distribution of disease bevavior states during follow-up according to age at onset
Adult onsetB1B2B3
At diagnosis56%21%23%
2 years50%19%31%
5 years45%20%35%
10 years41%21%38%
15 years40%21%39%
Tables 1 and 2 Distribution of disease bevavior states during follow-up according to age at onset
Pediatric onsetB1B2B3
At diagnosis62%15%23%
2 years52%17%31%
5 years44%18%38%
10 years42%16%42%
15 years39%14%47%

Similarly, time to change in disease behaviour from B1 to B2/B3 disease was not significantly different between pediatric and adult onset CD in a Kaplan–Meier analysis. The probability of complicated disease behaviour was 27.5% and 51.7% in the pediatric and 34.3% and 56.4% in the adult onset patients after 5‑ and 10-years of follow-up (Figure 1, p = NS).

Figure 1. Probability of survival without a disease behavior change in patients with inflammatory (B1) disease

Conclusions: The long-term evolution of the disease behaviour in pediatric and adult onset CD patients was not different in this population-based incident cohort.