TY - JOUR
T1 - Early Course of Inflammatory Bowel Disease in a Population-Based Inception Cohort Study from 8 Countries in Asia and Australia
AU - Ng, Siew C.
AU - Zeng, Zhirong
AU - Niewiadomski, Ola
AU - Tang, Whitney
AU - Bell, Sally
AU - Kamm, Michael A.
AU - Hu, Pinjin
AU - De Silva, H. Janaka
AU - Niriella, Madunil A.
AU - Udara, W. S.A.A.Yasith
AU - Ong, David
AU - Ling, Khoon Lin
AU - Ooi, Choon Jin
AU - Hilmi, Ida
AU - Lee Goh, Khean
AU - Ouyang, Qin
AU - Wang, Yu Fang
AU - Wu, Kaichun
AU - Wang, Xin
AU - Pisespongsa, Pises
AU - Manatsathit, Sathaporn
AU - Aniwan, Satimai
AU - Limsrivilai, Julajak
AU - Gunawan, Jeffri
AU - Simadibrata, Marcellus
AU - Abdullah, Murdani
AU - Tsang, Steve W.C.
AU - Lo, Fu Hang
AU - Hui, Aric J.
AU - Chow, Chung Mo
AU - Yu, Hon Ho
AU - Li, Mo Fong
AU - Ng, Ka Kei
AU - Ching, Jessica Y.L.
AU - Chan, Victor
AU - Wu, Justin C.Y.
AU - Chan, Francis K.L.
AU - Chen, Minhu
AU - Sung, Joseph J.Y.
N1 - Publisher Copyright:
© 2016 AGA Institute.
PY - 2016/1/1
Y1 - 2016/1/1
N2 - Background & Aims The incidence of inflammatory bowel disease (IBD) is increasing in Asia, but little is known about disease progression in this region. The Asia-Pacific Crohn's and Colitis Epidemiology Study was initiated in 2011, enrolling subjects from 8 countries in Asia (China, Hong Kong, Indonesia, Sri Lanka, Macau, Malaysia, Singapore, and Thailand) and Australia. We present data from this ongoing study. Methods We collected data on 413 patients diagnosed with IBD (222 with ulcerative colitis [UC], 181 with Crohn's disease [CD], 10 with IBD unclassified; median age, 37 y) from 2011 through 2013. We analyzed the disease course and severity and mortality. Risks for medical and surgical therapies were assessed using Kaplan-Meier analysis. Results The cumulative probability that CD would change from inflammatory to stricturing or penetrating disease was 19.6%. The cumulative probabilities for use of immunosuppressants or anti-tumor necrosis factor agents were 58.9% and 12.0% for patients with CD, and 12.7% and 0.9% for patients with UC, respectively. Perianal CD was associated with an increased risk of anti-tumor necrosis factor therapy within 1 year of its diagnosis (hazard ratio, 2.97; 95% confidence interval, 1.09-8.09). The cumulative probabilities for surgery 1 year after diagnosis were 9.1% for patients with CD and 0.9% for patients with UC. Patients with CD and penetrating disease had a 7-fold increase for risk of surgery, compared with patients with inflammatory disease (hazard ratio, 7.67; 95% confidence interval, 3.93-14.96). The overall mortality for patients with IBD was 0.7%. Conclusions In a prospective population-based study, we found that the early course of disease in patients with IBD in Asia was comparable with that of the West. Patients with CD frequently progress to complicated disease and have accelerated use of immunosuppressants. Few patients with early stage UC undergo surgery in Asia. Increasing our understanding of IBD progression in different populations can help optimize therapy and improve outcomes.
AB - Background & Aims The incidence of inflammatory bowel disease (IBD) is increasing in Asia, but little is known about disease progression in this region. The Asia-Pacific Crohn's and Colitis Epidemiology Study was initiated in 2011, enrolling subjects from 8 countries in Asia (China, Hong Kong, Indonesia, Sri Lanka, Macau, Malaysia, Singapore, and Thailand) and Australia. We present data from this ongoing study. Methods We collected data on 413 patients diagnosed with IBD (222 with ulcerative colitis [UC], 181 with Crohn's disease [CD], 10 with IBD unclassified; median age, 37 y) from 2011 through 2013. We analyzed the disease course and severity and mortality. Risks for medical and surgical therapies were assessed using Kaplan-Meier analysis. Results The cumulative probability that CD would change from inflammatory to stricturing or penetrating disease was 19.6%. The cumulative probabilities for use of immunosuppressants or anti-tumor necrosis factor agents were 58.9% and 12.0% for patients with CD, and 12.7% and 0.9% for patients with UC, respectively. Perianal CD was associated with an increased risk of anti-tumor necrosis factor therapy within 1 year of its diagnosis (hazard ratio, 2.97; 95% confidence interval, 1.09-8.09). The cumulative probabilities for surgery 1 year after diagnosis were 9.1% for patients with CD and 0.9% for patients with UC. Patients with CD and penetrating disease had a 7-fold increase for risk of surgery, compared with patients with inflammatory disease (hazard ratio, 7.67; 95% confidence interval, 3.93-14.96). The overall mortality for patients with IBD was 0.7%. Conclusions In a prospective population-based study, we found that the early course of disease in patients with IBD in Asia was comparable with that of the West. Patients with CD frequently progress to complicated disease and have accelerated use of immunosuppressants. Few patients with early stage UC undergo surgery in Asia. Increasing our understanding of IBD progression in different populations can help optimize therapy and improve outcomes.
KW - ACCESS
KW - Natural History
KW - Risk Factor
KW - Treatment
UR - https://www.scopus.com/pages/publications/84952646204
U2 - 10.1053/j.gastro.2015.09.005
DO - 10.1053/j.gastro.2015.09.005
M3 - Article
C2 - 26385074
AN - SCOPUS:84952646204
SN - 0016-5085
VL - 150
SP - 86-95.e3
JO - Gastroenterology
JF - Gastroenterology
IS - 1
ER -