P768 Long-term prognosis of Crohn’s disease and its temporal changes between 1986 and 2015 in a population-based cohort in the Songpa-Kangdong district of Seoul, Korea
B.D. Ye1, H. Park2, S.H. Kim3, S.N. Hong4, H. Yoon5, Y.J. Kim6, S.I. Seo7, K.H. Rhee8, Y.H. Kim4, K.H. Kim7, J.M. Cha9, S.Y. Park10, S.K. Jeong11, J.S. Kim12, J.P. Im12, J. Jang3, J.H. Kim13, S.O. Suh14, Y.K. Kim15, S.H. Park1, S.K. Yang1, On behalf of the Songpa-Kangdong Inflammatory Bowel Disease (SK-IBD) Study Group
1University of Ulsan College of Medicine- Asan Medical Center, Department of Gastroenterology and Inflammatory Bowel Disease Center, Seoul, Republic of Korea, 2Daehang Hospital, Department of Gastroenterology, Seoul, Republic of Korea, 3VHS Medical Center, Department of Internal Medicine, Seoul, Republic of Korea, 4Samsung Medical Center- Sungkyunkwan University School of Medicine, Department of Medicine, Seoul, Republic of Korea, 5Seoul National University Bundang Hospital, Department of Internal Medicine, Seongnam, Republic of Korea, 6Asan Medical Center- University of Ulsan College of Medicine, Department of Clinical Epidemiology and Biostatistics, Seoul, Republic of Korea, 7Kangdong Sacred Heart Hospital- Hallym University College of Medicine, Department of Internal Medicine, Seoul, Republic of Korea, 8Hansol Hospital, Department of Internal Medicine, Seoul, Republic of Korea, 9Kyung Hee University Hospital at Gang Dong- Kyung Hee University College of Medicine, Department of Internal Medicine, Seoul, Republic of Korea, 10Kangdong Seoul Colon and Rectal Surgery, Department of Surgery, Seoul, Republic of Korea, 11Yang Hospital, Department of Surgery, Seoul, Republic of Korea, 12Seoul National University College of Medicine, Department of Internal Medicine and Liver Research Institute, Seoul, Republic of Korea, 13Konkuk University Medical Center, Department of Internal Medicine, Seoul, Republic of Korea, 14National Police Hospital, Department of Internal Medicine, Seoul, Republic of Korea, 15Jamsil Seoul Surgical Clinic, Department of Surgery, Seoul, Republic of Korea
Background
No previous population-based study has evaluated the natural course of Crohn’s disease (CD) over three decades in non-Caucasians. We previously reported a 30-year trend in the epidemiology of inflammatory bowel disease (IBD) in the Songpa-Kangdong (SK) District of Seoul, Korea between 1986 and 2015 (1). In this study, we aimed to analyse the long-term natural course of Korean patients with CD in the SK-IBD population-based cohort.
Methods
All patients newly diagnosed with CD between 1986 and 2015 were enrolled in this study. To assess the temporal trends in treatment paradigms and in the prognosis of CD, patients were divided into two cohorts according to the year of CD diagnosis: cohort 1, 1986–2003 and cohort 2, 2004–2015 (the anti-tumour necrosis factor [anti-TNF] era). Disease characteristics at diagnosis, outcomes and their predictors were evaluated.
Results
A total of 418 patients were enrolled. There were 318 males (76.1%) and median age at CD diagnosis was 22 years (interquartile range [IQR], 18–29). Disease location at CD diagnosis was ileal in 104 patients (24.9%), colonic in 39 (9.3%), and ileocolonic in 275 (65.8%). Disease behaviour at CD diagnosis was inflammatory in 339 patients (81.1%), stricturing in 34 (8.1%), and penetrating in 45 (10.8%). Perianal fistula/abscess was present in 43.3% (n = 181) before or at CD diagnosis. During the median follow-up of 108.1 months, the overall use of systemic corticosteroids, thiopurines, and anti-TNF agents was 57.4%, 80.9%, and 34.2%, respectively. Compared with the cohort 1, the cumulative probability of commencing corticosteroids decreased (
Conclusion
Korean patients showed a similar clinical course and intestinal resection rate compared with Western patients. The risk of intestinal resection has decreased in the anti-TNF era.
Park SH, Kim YJ, Rhee KH, et al. A 30-year Trend Analysis in the Epidemiology of Inflammatory Bowel Disease in the Songpa-Kangdong District of Seoul, Korea in 1986–2015. J Crohns Colitis 2019;13(11):1410–1417.