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  • 1. Aims and Scope

    Gut and Liver is an international journal of gastroenterology, focusing on the gastrointestinal tract, liver, biliary tree, pancreas, motility, and neurogastroenterology. Gut atnd Liver delivers up-to-date, authoritative papers on both clinical and research-based topics in gastroenterology. The Journal publishes original articles, case reports, brief communications, letters to the editor and invited review articles in the field of gastroenterology. The Journal is operated by internationally renowned editorial boards and designed to provide a global opportunity to promote academic developments in the field of gastroenterology and hepatology. +MORE

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    Yong Chan Lee Professor of Medicine
    Director, Gastrointestinal Research Laboratory
    Veterans Affairs Medical Center, Univ. California San Francisco
    San Francisco, USA

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    Jong Pil Im Seoul National University College of Medicine, Seoul, Korea
    Robert S. Bresalier University of Texas M. D. Anderson Cancer Center, Houston, USA
    Steven H. Itzkowitz Mount Sinai Medical Center, NY, USA
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Changes in the Long-term Prognosis of Crohn’s Disease between 1986 and 2015: The Population-Based Songpa-Kangdong Inflammatory Bowel Disease Cohort Study

Byong Duk Ye1 , Sung Noh Hong2 , Seung In Seo3 , Ye-Jee Kim4 , Jae Myung Cha5 , Kyoung Hoon Rhee6 , Hyuk Yoon7 , Young-Ho Kim2 , Kyung Ho Kim3 , Sun Yong Park8 , Seung Kyu Jeong9 , Ji Hyun Lee10 , Hyunju Park11 , Joo Sung Kim12 , Jong Pil Im12 , Sung Hoon Kim13 , Jisun Jang13 , Jeong Hwan Kim14 , Seong O Suh15 , Young Kyun Kim16 , Sang Hyoung Park1 , and Suk-Kyun Yang1 , on behalf of the Songpa-Kangdong Inflammatory Bowel Disease (SKIBD) Study Group

1Department of Gastroenterology and Inflammatory Bowel Disease Center, Asan Medical Center, University of Ulsan College of Medicine, 2Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 3Department of Internal Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, 4Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, 5Department of Internal Medicine, Kyung Hee University Hospital at Gangdong, Kyung Hee University College of Medicine, 6Department of Internal Medicine, Hansol Hospital, Seoul, 7Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, 8Kangdong Seoul Colon and Rectal Surgery, 9Department of Surgery, Yang Hospital, 10Digestive Endoscopic Center, Seoul Song Do Colorectal Hospital, 11Department of Gastroenterology, Daehang Hospital, 12Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, 13Department of Internal Medicine, VHS Medical Center, 14Department of Internal Medicine, Konkuk University Medical Center, 15Department of Internal Medicine, National Police Hospital, and 16Jamsil Seoul Surgical Clinic, Seoul, Korea

Correspondence to:Suk-Kyun Yang
ORCID https://orcid.org/0000-0003-2772-2575
E-mail sky@amc.seoul.kr

Byong Duk Ye, Sung Noh Hong, and Seung In Seo contributed equally to this work as first authors.

Received: January 29, 2021; Revised: March 23, 2021; Accepted: April 12, 2021

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Gut and Liver

Published online June 22, 2021

Copyright © Gut and Liver.

Abstract

Background/Aims: The long-term course of Crohn’s disease (CD) has never been evaluated in non-Caucasian population-based cohorts. The aim of the present study was to evaluate the longterm prognosis of Korean CD patients in the well-defined population-based Songpa-Kangdong inflammatory bowel disease cohort.
Methods: Outcomes of disease and their predictors were evaluated for 418 patients diagnosed with CD between 1986 and 2015.
Results: During a median of 123 months, systemic corticosteroids, thiopurines, and anti-tumor necrosis factor (TNF) agents were administered to 58.6%, 81.3%, and 37.1% of patients, respectively. Over time, the cumulative probability of starting corticosteroids significantly decreased (p=0.001), whereas that of starting thiopurines and anti-TNFs significantly increased (both p<0.001). The cumulative probability of behavioral progression was 54.5% at 20 years, and it significantly decreased during the anti-TNF era. Intestinal resection was required for 113 patients (27.0%). The cumulative probabilities of intestinal resection at 1, 5, 10, 20, and 25 years after CD diagnosis were 12.7%, 16.5%, 23.8%, 45.1%, and 51.2%, respectively. Multivariable Cox regression analysis identified stricturing behavior at diagnosis (adjusted hazard ratio [aHR], 2.70; 95% confidence interval [CI], 1.55 to 4.71), penetrating behavior at diagnosis (aHR, 11.15; 95% CI, 6.91 to 17.97), and diagnosis of CD during the anti-TNF era (aHR, 0.51; 95% CI, 0.35 to 0.76) as independently associated with intestinal resection. The standardized mortality ratio among CD patients was 1.36 (95% CI, 0.59 to 2.68).
Conclusions: The long-term prognosis of Korean patients with CD is at least as good as that of Western CD patients, as indicated by the low intestinal resection rate. Moreover, behavioral progression and intestinal resection rates have decreased over the past 3 decades.

Keywords: SK-IBD, Crohn disease, Prognosis, Korea


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Gut and Liver

Published online June 22, 2021

Copyright © Gut and Liver.

Changes in the Long-term Prognosis of Crohn’s Disease between 1986 and 2015: The Population-Based Songpa-Kangdong Inflammatory Bowel Disease Cohort Study

Byong Duk Ye1 , Sung Noh Hong2 , Seung In Seo3 , Ye-Jee Kim4 , Jae Myung Cha5 , Kyoung Hoon Rhee6 , Hyuk Yoon7 , Young-Ho Kim2 , Kyung Ho Kim3 , Sun Yong Park8 , Seung Kyu Jeong9 , Ji Hyun Lee10 , Hyunju Park11 , Joo Sung Kim12 , Jong Pil Im12 , Sung Hoon Kim13 , Jisun Jang13 , Jeong Hwan Kim14 , Seong O Suh15 , Young Kyun Kim16 , Sang Hyoung Park1 , and Suk-Kyun Yang1 , on behalf of the Songpa-Kangdong Inflammatory Bowel Disease (SKIBD) Study Group

1Department of Gastroenterology and Inflammatory Bowel Disease Center, Asan Medical Center, University of Ulsan College of Medicine, 2Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 3Department of Internal Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, 4Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, 5Department of Internal Medicine, Kyung Hee University Hospital at Gangdong, Kyung Hee University College of Medicine, 6Department of Internal Medicine, Hansol Hospital, Seoul, 7Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, 8Kangdong Seoul Colon and Rectal Surgery, 9Department of Surgery, Yang Hospital, 10Digestive Endoscopic Center, Seoul Song Do Colorectal Hospital, 11Department of Gastroenterology, Daehang Hospital, 12Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, 13Department of Internal Medicine, VHS Medical Center, 14Department of Internal Medicine, Konkuk University Medical Center, 15Department of Internal Medicine, National Police Hospital, and 16Jamsil Seoul Surgical Clinic, Seoul, Korea

Correspondence to:Suk-Kyun Yang
ORCID https://orcid.org/0000-0003-2772-2575
E-mail sky@amc.seoul.kr

Byong Duk Ye, Sung Noh Hong, and Seung In Seo contributed equally to this work as first authors.

Received: January 29, 2021; Revised: March 23, 2021; Accepted: April 12, 2021

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background/Aims: The long-term course of Crohn’s disease (CD) has never been evaluated in non-Caucasian population-based cohorts. The aim of the present study was to evaluate the longterm prognosis of Korean CD patients in the well-defined population-based Songpa-Kangdong inflammatory bowel disease cohort.
Methods: Outcomes of disease and their predictors were evaluated for 418 patients diagnosed with CD between 1986 and 2015.
Results: During a median of 123 months, systemic corticosteroids, thiopurines, and anti-tumor necrosis factor (TNF) agents were administered to 58.6%, 81.3%, and 37.1% of patients, respectively. Over time, the cumulative probability of starting corticosteroids significantly decreased (p=0.001), whereas that of starting thiopurines and anti-TNFs significantly increased (both p<0.001). The cumulative probability of behavioral progression was 54.5% at 20 years, and it significantly decreased during the anti-TNF era. Intestinal resection was required for 113 patients (27.0%). The cumulative probabilities of intestinal resection at 1, 5, 10, 20, and 25 years after CD diagnosis were 12.7%, 16.5%, 23.8%, 45.1%, and 51.2%, respectively. Multivariable Cox regression analysis identified stricturing behavior at diagnosis (adjusted hazard ratio [aHR], 2.70; 95% confidence interval [CI], 1.55 to 4.71), penetrating behavior at diagnosis (aHR, 11.15; 95% CI, 6.91 to 17.97), and diagnosis of CD during the anti-TNF era (aHR, 0.51; 95% CI, 0.35 to 0.76) as independently associated with intestinal resection. The standardized mortality ratio among CD patients was 1.36 (95% CI, 0.59 to 2.68).
Conclusions: The long-term prognosis of Korean patients with CD is at least as good as that of Western CD patients, as indicated by the low intestinal resection rate. Moreover, behavioral progression and intestinal resection rates have decreased over the past 3 decades.

Keywords: SK-IBD, Crohn disease, Prognosis, Korea

Gut and Liver

Vol.15 No.5
September, 2021

pISSN 1976-2283
eISSN 2005-1212

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