Bowel damage and its correlation with the disability index in patients with recently diagnosed Crohn´s Disease

التفاصيل البيبلوغرافية
العنوان: Bowel damage and its correlation with the disability index in patients with recently diagnosed Crohn´s Disease
المؤلفون: Torres, Joana, Roager Madsen, Gorm, Burisch, Johan, Wong, Charlotte, Arebi, Naila, Bonnet-Dodel, M, Buisson, Anthony, Gatt, Kelly, Ellul, Pierre, VIEUJEAN, Sophie, Ordas, Ingrid, Duricova, Dana, Rodríguez-Lago, Iago, Sebastian, Shaji, Mocanu, Irina, Kaimakliotis, I, Goldis, Adrian, Hernandez, V, Nachury, Maria, Fumery, Mathurin, Alloca, Mariangela, Pedersen, Natalia, Barberio, Birgida, Guedes, Ana Filipa, Ribeiro, Raquel, Ungaro, Ryan, Mary, Jean-Yves, Bigot, Noemie, Lambert, Jerôme, Colombel, Jean-Frederic
المصدر: European Crohn's and Colitis Organisation 2024, Stockholm, Sweden [SE], 21-24 February 2024
سنة النشر: 2024
مصطلحات موضوعية: Crohn’s disease, bowel damage, disability, Human health sciences, Gastroenterology & hepatology, Sciences de la santé humaine, Gastroentérologie & hépatologie
الوصف: Background: Crohn’s disease (CD) progression can lead to bowel damage (BD) and disability. However, the longitudinal characterization of BD anddisability in early CD patients remains limited.Methods: The Crohn´s Disease Cohort (CROCO) is a multicentre, European cohort study of newly diagnosed CD patients (<12 months followingdiagnosis) intended to prospectively characterize BD progression and disability. At one year following inclusion (Y1), BD progression was evaluatedusing the Lémann Index (LI). Magnetic resonance enterography was completed by all patients, with additional endoscopy and/or pelvic MRIbased on disease location. Absence of BD was defined as a LI=0, and any presence of bowel damage was indicated by LI>0. Disability was assessedusing the validated IBD-disability index (IBD-DI) encompassing various domains. We report the LI at Y1 and its association with significant diseasefeatures and with the IBD-DI.Results: Among the 261 included patients, 135 have completed the Y1 visit, with 100 having their LI calculated [57% male, median age at diagnosisof 36 years old (IQR 26-48)]. Most patients (90%) had ileal or ileocolonic involvement, 68% had inflammatory phenotype, and 11% had perianaldisease. At inclusion, 7% of patients had undergone surgery (5 intestinal and 2 perianal), and 53% had initiated biological therapy within the firstyear of disease, primarily anti-TNF in mono or combination therapy. Of those with stricturing (B2) or penetrating (B3) behaviour, 77% and 79%,respectively, were on anti-TNF therapy. Overall, 61% of the patients exhibited some degree of BD (LI>0), yet the median LI at Y1 was low [0.6(IQR 0-2)]. Univariate analysis revealed an association between the presence of any bowel damage at Y1 and disease behaviour at inclusion (B2OR 3.33, 95%CI 0.84-13.18 and B3 OR 8.5, 95%CI 1.82, 39.66; p<0.01). Additionally, there was a significant association with anti-TNF therapy(OR 2.88, 95%CI 1.24-6.66, p=0.012). In a multivariate logistic model, only older age at diagnosis appeared protective against any BD (Table 1).Among those evaluated for the LI, 84 completed the IBD-DI at Y1. The median IBD-DI was 17.3 (IQR 10.7-32.6) and 30% experienced moderateto-severe disability (IBD-DI>35). No association was observed between LI and IBD-DI at Y1 (OR 1.09, 95%CI 0.39-3.04, p=0.86) and there wereno differences in the median LI across disability categories (p=0.67) (Figure 1).Conclusion: In a cohort of newly diagnosed CD patients, one-third exhibited no bowel damage as per the LI evaluation. For those presenting anydegree of damage, the global LI remained low. No association was found with disability assessed by the IBD-DI. These data add to the growingconcept that early disease represents a window of opportunity.
نوع الوثيقة: conference paper not in proceedings
http://purl.org/coar/resource_type/c_18cp
conferencePaper
peer reviewed
اللغة: English
URL الوصول: https://orbi.uliege.be/handle/2268/312049
حقوق: restricted access
http://purl.org/coar/access_right/c_16ec
info:eu-repo/semantics/restrictedAccess
رقم الأكسشن: edsorb.312049
قاعدة البيانات: ORBi