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. 2022 Nov;9(1):e001016.
doi: 10.1136/bmjgast-2022-001016.

Variables associated with progression of moderate-to-severe Crohn's disease

Carolina da Silva Beda Sacramento  1 , Marina Pamponet Motta  1 , Candida de Oliveira Alves  1 , Jaciane Araujo Mota  2 , Lina Maria Goes de Codes  3 , Reginaldo Freitas Ferreira  4 , Pedro de Almeida Silva  4 , Larissa do Prado Palmiro  4 , Rafael Miranda Barbosa  4 , Mariana Nery Andrade  5 , Vitor Damasceno Andrade  6 , Vitor Brandão Vasconcelos  5 , Bernardo Wasconcellos Thiara  6 , Eduardo Martins Netto  7 , Genoile Oliveira Santana  8
Affiliations

Variables associated with progression of moderate-to-severe Crohn's disease

Carolina da Silva Beda Sacramento et al. BMJ Open Gastroenterol. 2022 Nov.

Abstract

Objective: Determine the variables associated with hospitalisations in patients with Crohn's disease and those associated with surgery, intestinal resection, hospital readmission, need for multiple operations and immunobiological agent use.

Design: A cross-sectional study was conducted from 2019 to 2021, using two centres for inflammatory bowel diseases in the Brazilian Public Health System.

Results: This study included 220 patients. Only perianal disease was associated with hospitalisation (31.6% vs 13.0%, p=0.012). Stricturing or penetrating behaviour (35.8% vs 12.6%, p<0.001) and perianal disease (45.9% vs 9.9%, p<0.001) were associated with surgery. Ileal or ileocolonic location (80.0% vs 46.5%, p=0.044) and stricturing or penetrating behaviour (68.0% vs 11.2%, p<0.001) were associated with intestinal resection. Steroids use at first Crohn's disease occurrence and postoperative complications were associated with hospital readmission and need for multiple operations, respectively. Age below 40 years at diagnosis (81.3% vs 62.0%, p=0.004), upper gastrointestinal tract involvement (21.8% vs 10.3%, p=0.040) and perianal disease (35.9% vs 16.3%, p<0.001) were associated with immunobiological agent use.

Conclusion: Perianal disease and stricturing or penetrating behaviour were associated with more than one significant outcome. Other variables related to Crohn's disease progression were age below 40 years at diagnosis, an ileal or ileocolonic disease localisation, an upper gastrointestinal tract involvement, the use of steroids at the first Crohn's disease occurrence and history of postoperative complications. These findings are similar to those in the countries with a high prevalence of Crohn's disease.

Keywords: CROHN'S DISEASE; INFLAMMATORY BOWEL DISEASE; SURGERY FOR IBD.

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Conflict of interest statement

Competing interests: CdSBS is researcher for Roche and Bristol; received support to participate in meetings for Janssen and Pfizer. MPM is speaker for Janssen and Takeda; researcher for Bristol, EMS and Roche; received support to participate in meetings for Janssen and Takeda. CdOA is researcher for Roche and Bristol; received support to participate in meetings for Pfizer and Ferring. JAM is speaker for Takeda, Janssen and UCB; researcher for Sanofi; received support to participate in meetings for Abbvie, Pfizer, Janssen and Takeda. LMGdC is speaker for Janssen; received support to participate in meetings for Janssen. GOS is speaker for Abbvie, Janssen, Takeda and Pfizer; researcher for Janssen, Lilly, Roche and Takeda; received support to participate in meetings for Janssen and Takeda. There is no conflict of interest associated with the others authors who contributed to this manuscript.

References

    1. Torres J, Mehandru S, Colombel J-F, et al. Crohn’s disease. The Lancet 2017;389:1741–55. 10.1016/S0140-6736(16)31711-1 - DOI - PubMed
    1. Golovics PA, Mandel MD, Lovasz BD, et al. Inflammatory bowel disease course in Crohn's disease: is the natural history changing? World J Gastroenterol 2014;20:3198–207. 10.3748/wjg.v20.i12.3198 - DOI - PMC - PubMed
    1. Smids C, Horjus Talabur Horje CS, Nierkens S, et al. Candidate serum markers in early Crohn's disease: predictors of disease course. J Crohns Colitis 2017;11:1090–100. 10.1093/ecco-jcc/jjx049 - DOI - PubMed
    1. Guizzetti L, Zou G, Khanna R, et al. Development of clinical prediction models for surgery and complications in Crohn's disease. J Crohns Colitis 2018;12:167–77. 10.1093/ecco-jcc/jjx130 - DOI - PMC - PubMed
    1. Torres J, Caprioli F, Katsanos KH, et al. Predicting outcomes to optimize disease management in inflammatory bowel diseases. J Crohns Colitis 2016;10:1385–94. 10.1093/ecco-jcc/jjw116 - DOI - PMC - PubMed

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