Crohn's Disease Phenotypes and Associations With Comorbidities, Surgery Risk, Medications and Nonmedication Approaches: The MAGIC in IMAGINE Study.

Crohn’s disease cohort study phenotype surgery

Journal

Inflammatory bowel diseases
ISSN: 1536-4844
Titre abrégé: Inflamm Bowel Dis
Pays: England
ID NLM: 9508162

Informations de publication

Date de publication:
27 Mar 2024
Historique:
received: 28 11 2023
medline: 28 3 2024
pubmed: 28 3 2024
entrez: 27 3 2024
Statut: aheadofprint

Résumé

We aimed to establish a cohort of persons with Crohn's disease (CD) enrolled from 14 Canadian centers to describe the contemporary presentation of CD in Canada. All enrollees were at least 18 years old and underwent chart review for phenotype documentation by Montreal Classification at time of enrollment, comorbidities, inflammatory bowel disease (IBD) and other surgeries, and use IBD and other therapies. Of 2112 adults, 59% were female, and the mean age was 44.1 (+/-14.9SD) years. The phenotype distribution was B1 = 50.4%, B2 = 22.4%, B3 = 17.3%, and missing information = 9.9%. Perineal disease was present in 14.2%. Pertaining to disease location, 35.2% of patients had disease in L1, 16.8% in L2, 48% in L3, and 0.4% in L4. There was no difference in phenotype by gender, anxiety score, depression score. Disease duration was significantly different depending on disease behavior type (B1 = 12.2 ± 10.1; B2 = 19.4 ± 12.9; B3 = 18.9 ± 11.8, P < .0001). Isolated colonic disease was much less likely to be fibrostenotic or penetrating than inflammatory disease. Penetrating disease was more likely to be associated with ileocolonic location than other locations. Perineal disease was most commonly seen in persons with B3 disease behavior (24%) than other behaviors (11% B1; 20% B2 disease, P < .0001) and more likely to be seen in ileocolonic disease (L3;19%) vs L2 (17%) and L1 (11%; P < .0001). Surgery related to IBD occurred across each behavior types at the following rates: B1 = 23%, B2 = 64%, and B3 = 74%. Inflammatory bowel disease-related surgery rates by location of disease were L1 = 48%, L2 = 21%, and L3 = 51%. In exploring this large contemporary CD cohort we have determined that inflammatory disease is the main CD phenotype in Canada and that CD-related surgery remains very common.

Sections du résumé

BACKGROUND BACKGROUND
We aimed to establish a cohort of persons with Crohn's disease (CD) enrolled from 14 Canadian centers to describe the contemporary presentation of CD in Canada.
METHODS METHODS
All enrollees were at least 18 years old and underwent chart review for phenotype documentation by Montreal Classification at time of enrollment, comorbidities, inflammatory bowel disease (IBD) and other surgeries, and use IBD and other therapies.
RESULTS RESULTS
Of 2112 adults, 59% were female, and the mean age was 44.1 (+/-14.9SD) years. The phenotype distribution was B1 = 50.4%, B2 = 22.4%, B3 = 17.3%, and missing information = 9.9%. Perineal disease was present in 14.2%. Pertaining to disease location, 35.2% of patients had disease in L1, 16.8% in L2, 48% in L3, and 0.4% in L4. There was no difference in phenotype by gender, anxiety score, depression score. Disease duration was significantly different depending on disease behavior type (B1 = 12.2 ± 10.1; B2 = 19.4 ± 12.9; B3 = 18.9 ± 11.8, P < .0001). Isolated colonic disease was much less likely to be fibrostenotic or penetrating than inflammatory disease. Penetrating disease was more likely to be associated with ileocolonic location than other locations. Perineal disease was most commonly seen in persons with B3 disease behavior (24%) than other behaviors (11% B1; 20% B2 disease, P < .0001) and more likely to be seen in ileocolonic disease (L3;19%) vs L2 (17%) and L1 (11%; P < .0001). Surgery related to IBD occurred across each behavior types at the following rates: B1 = 23%, B2 = 64%, and B3 = 74%. Inflammatory bowel disease-related surgery rates by location of disease were L1 = 48%, L2 = 21%, and L3 = 51%.
CONCLUSIONS CONCLUSIONS
In exploring this large contemporary CD cohort we have determined that inflammatory disease is the main CD phenotype in Canada and that CD-related surgery remains very common.

Identifiants

pubmed: 38537257
pii: 7636217
doi: 10.1093/ibd/izae055
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Subventions

Organisme : Canadian Institute of Health Research
ID : RN279389-35803
Organisme : McMaster University
Organisme : University of Calgary, University of Alberta
Organisme : Research Manitoba
Organisme : Queen's University
Organisme : Dalhousie University
Organisme : Montreal Heart Institute Research Centre
Organisme : Takeda Pharmaceutical Company
Organisme : Allergan Incorporated
Organisme : Alberta Innovates
Organisme : Crohn's and Colitis Canada

Informations de copyright

© 2024 Crohn’s & Colitis Foundation. Published by Oxford University Press on behalf of Crohn’s & Colitis Foundation.

Auteurs

Charles N Bernstein (CN)

Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
University of Manitoba Inflammatory Bowel Disease Clinical and Research Centre, Winnipeg, Canada.

Remo Panaccione (R)

Division of Gastroenterology and Hepatology, Departments of Medicine, University of Calgary, Calgary, Alberta, Canada.

Zoann Nugent (Z)

Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
University of Manitoba Inflammatory Bowel Disease Clinical and Research Centre, Winnipeg, Canada.

Deborah A Marshall (DA)

Departments of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.

Gilaad G Kaplan (GG)

Division of Gastroenterology and Hepatology, Departments of Medicine, University of Calgary, Calgary, Alberta, Canada.
Departments of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.

Stephen Vanner (S)

Queens University, Kingston, Ontario, Canada.

Levinus A Dieleman (LA)

Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.

Lesley A Graff (LA)

University of Manitoba Inflammatory Bowel Disease Clinical and Research Centre, Winnipeg, Canada.
Department of Clinical Health Psychology, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.

Anthony Otley (A)

Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada.

Jennifer Jones (J)

Department of Internal Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.

Michelle Buresi (M)

Division of Gastroenterology and Hepatology, Departments of Medicine, University of Calgary, Calgary, Alberta, Canada.

Sanjay Murthy (S)

Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada.

Mark Borgaonkar (M)

Department of Medicine, Memorial University, St Johns, Newfoundland, Canada.

Brian Bressler (B)

Department of Medicine, University of British Columbia, Vancouver, BC, Canada.

Alain Bitton (A)

Department of Medicine, McGill University, Montreal, Quebec, Canada.

Kenneth Croitoru (K)

Department of Medicine, University of Toronto, Toronto, Ontario, Canada.

Sacha Sidani (S)

Department of Medicine, University of Montreal, Montreal, Quebec, Canada.

Aida Fernandes (A)

Department of Medicine, McMaster University, Hamilton, Ontario, Canada.

Paul Moayyedi (P)

Department of Medicine, McMaster University, Hamilton, Ontario, Canada.

Classifications MeSH