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P428. Long-term clinical outcomes of Korean patients with Crohn's disease

S.Y. Choi1, N.H. Kim1, Y.S. Jung1, C.M. Moon1, S.Y. Lee1, E.R. Kim2, Y.H. Kim2, C.K. Lee3, S.H. Lee4, J.H. Kim5, K.C. Huh6, S.A. Jung7, S.M. Yoon8, H.J. Song9, S.J. Boo9, H.J. Jang10, Y.S. Kim11, K.M. Lee12, J.E. Shin13, D.I. Park1, 1Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Internal medicine, Seoul, South Korea, 2Samsung Medical Center, Sungkyunkwan University School of Medicine, Medicine, Seoul, South Korea, 3Kyung Hee University School of Medicine, Internal medicine, Seoul, South Korea, 4Soonchunhyang University College of Medicine, Internal medicine, Cheonan, South Korea, 5Dongguk University College of Medicine, Internal medicine, Goyang, South Korea, 6Konyang University College of Medicine, Internal medicine, Daejeon, South Korea, 7Ewha Womans University, Internal medicine, Seoul, South Korea, 8Chungbuk National University Hospital, Internal medicine, Cheongju, South Korea, 9Jeju National University School of Medicine, Internal medicine, Jeju, South Korea, 10Hallym University Hangang Sacred Heart Hospital, Internal medicine, Seoul, South Korea, 11Seoul Paik Hospital, Inje University College of Medicine, Internal medicine, Seoul, South Korea, 12St. Vincent's Hospital, The Catholic University of Korea College of Medicine, Internal medicine, Suwon, South Korea, 13Dankook University College of Medicine, Internal medicine, Cheonan, South Korea

Background

Several recent studies have reported that the early use of Infliximab (IFX) improves the prognosis of Crohn's disease (CD). However, these studies have been conducted exclusively in Western countries, and no data are available in Asian populations. The aim of this study was to evaluate the impact of early use of IFX on the prognosis of Korean CD.

Methods

Patients with an established diagnosis of CD between July 1987 and January 2012 were investigated in 13 university hospitals in Korea. Two groups were identified by diagnosis date: the first group included patients diagnosed from July 1987 to December 2005 and the second from January 2006 to January 2012, because insurance covered IFX treatment since August 2005. We compared the cumulative probabilities of operation and reoperation between two groups using the Kaplan–Meier method and a log-rank test.

Results

Of a total 721 patients, 443 (61.4%) were the second group. Although the cumulative probabilities of immunosuppressant (P < 0.001) and IFX use (P < 0.001) after diagnosis were significantly higher in the second group, there were no significant differences in cumulative probabilities of operation (P = 0.905) and reoperation (P = 0.418) between two groups.

Conclusion

The early use of IFX did not reduce CD-related surgery requirements in Korean patient with CD. Our results suggest that the early use of IFX may have little impact in the clinical outcome of Korean CD in the setting of a conventional step-up algorithm.