J Crohns Colitis. 2022 Sep 10:jjac132. doi: 10.1093/ecco-jcc/jjac132. Online ahead of print.
ABSTRACT
BACKGROUND AND AIMS: The number of prospective population-based studies on Crohn’s disease(CD) is still limited from Eastern Europe. The present study is a continuation of the Veszprem IBD cohort. Our aim was to analyze incidence, prevalence, disease phenotype, treatment strategy, disease course and surgical outcomes in a prospective population-based inception cohort including CD patients diagnosed between 2007 and 2018.
METHODS: 421 consecutive inception patients were included (male/female:237/184; mean age at diagnosis: 33.3±16.2years). Both in-hospital and outpatient records were collected and comprehensively reviewed. Demographic data was derived from the Hungarian Central Statistical Office.
RESULTS: Mean incidence rate was 9.9 (CI95%: 9.0-10.9)/10 5 person-years in this 12-year period. Prevalence rate was 236.8 (CI95%: 220.8-252.8) in 2015. 17.6% and 20.0% of the patients had stenosing(B2) and penetrating(B3) disease behavior at diagnosis. The probability of disease behavior progression from luminal to B2/B3 phenotype was 14.7%(SE:2.2) at 5 years after diagnosis. Distribution of maximal therapeutic steps during the total follow-up (8.5y, SD:3.3) were 5-ASA in 15.7%, corticosteroids in 14.3%, immunosuppressives in 42.5% and biologic therapy in 26.2%. The probability of receiving biological therapy after diagnosis was 20.9%(SE:2.0) at 5 years. The probability of first resective surgery was 20.7%(SE:2.0) at 1 year, 26.1%(SE:2.2) at 5 years and 30.7%(SE:2.4) at 10 years, while perianal surgery rate was 31.3% among patients with perianal involvement.
CONCLUSIONS: The incidence of CD in Hungary was high, similar to high-incidence areas in Western Europe. Treatment strategies are reflecting the biological era. Disease behavior progression was lower, as well as long-term (10y) surgery rates decreased compared to data from previous decades.
PMID:36087109 | DOI:10.1093/ecco-jcc/jjac132
