Crohn's disease prognosis and early immunomodulator therapy: Results from the CONNECT study

Bun Kim, Jae Hee Cheon, Hyun Jin Moon, Yi Rang Park, Byong Duk Ye, Suk Kyun Yang, Geom Seog Seo, Byung Ik Jang, You Sun Kim, Joo Sung Kim, Dong Soo Han, Young Ho Kim, Won Ho Kim

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Background: It is unknown whether the treatment initiating time of immunomodulators such as thiopurines affects the course of Crohn's disease (CD). We evaluated the efficacy of early immunomodulator therapy (EIT) on the prognosis of patients with CD. Methods: We retrospectively analyzed 1157 patients with CD who were enrolled in the CrOhn's disease cliNical NEtwork and CohorT study and received immunomodulator therapy. The patients were divided into an EIT group and a conventional therapy group based on whether immunomodulators were initiated within six months after being diagnosed with CD. We compared the rates of intestinal surgery, bowel complications, and hospitalization because of CD between the groups. Results: Patient age at diagnosis and sex were not significantly different between the two groups. The mean duration of follow-up was 105.8±51.5months. A Kaplan-Meier analysis identified that the EIT group was superior to the conventional therapy group in terms of delaying surgery (P=0.017). In multivariate analysis, EIT was an independent predicting factor associated with delaying the onset of complications (P=0.050). Patients were divided into two groups based on the year of CD diagnosis: From 1982 to 1999 (A) and from 2000 to 2008 (B). In group A, the time from diagnosis to the start of immunomodulatory therapy was longer (P<0.001), and the time to first intestinal surgery was shorter than group B (P=0.002). Conclusions: The early use of immunomodulators was associated with a good prognosis as defined by a need for surgery and the occurrence of complications in CD in our multicenter study.

Original languageEnglish
Pages (from-to)126-132
Number of pages7
JournalJournal of Gastroenterology and Hepatology (Australia)
Volume31
Issue number1
DOIs
Publication statusPublished - 2016 Jan 1

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Immunologic Factors
Secondary Prevention
Crohn Disease
Group Psychotherapy
Immunomodulation
Kaplan-Meier Estimate
Multicenter Studies
Hospitalization
Cohort Studies
Multivariate Analysis
Therapeutics

All Science Journal Classification (ASJC) codes

  • Hepatology
  • Gastroenterology

Cite this

Kim, Bun ; Cheon, Jae Hee ; Moon, Hyun Jin ; Park, Yi Rang ; Ye, Byong Duk ; Yang, Suk Kyun ; Seo, Geom Seog ; Jang, Byung Ik ; Kim, You Sun ; Kim, Joo Sung ; Han, Dong Soo ; Kim, Young Ho ; Kim, Won Ho. / Crohn's disease prognosis and early immunomodulator therapy : Results from the CONNECT study. In: Journal of Gastroenterology and Hepatology (Australia). 2016 ; Vol. 31, No. 1. pp. 126-132.
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title = "Crohn's disease prognosis and early immunomodulator therapy: Results from the CONNECT study",
abstract = "Background: It is unknown whether the treatment initiating time of immunomodulators such as thiopurines affects the course of Crohn's disease (CD). We evaluated the efficacy of early immunomodulator therapy (EIT) on the prognosis of patients with CD. Methods: We retrospectively analyzed 1157 patients with CD who were enrolled in the CrOhn's disease cliNical NEtwork and CohorT study and received immunomodulator therapy. The patients were divided into an EIT group and a conventional therapy group based on whether immunomodulators were initiated within six months after being diagnosed with CD. We compared the rates of intestinal surgery, bowel complications, and hospitalization because of CD between the groups. Results: Patient age at diagnosis and sex were not significantly different between the two groups. The mean duration of follow-up was 105.8±51.5months. A Kaplan-Meier analysis identified that the EIT group was superior to the conventional therapy group in terms of delaying surgery (P=0.017). In multivariate analysis, EIT was an independent predicting factor associated with delaying the onset of complications (P=0.050). Patients were divided into two groups based on the year of CD diagnosis: From 1982 to 1999 (A) and from 2000 to 2008 (B). In group A, the time from diagnosis to the start of immunomodulatory therapy was longer (P<0.001), and the time to first intestinal surgery was shorter than group B (P=0.002). Conclusions: The early use of immunomodulators was associated with a good prognosis as defined by a need for surgery and the occurrence of complications in CD in our multicenter study.",
author = "Bun Kim and Cheon, {Jae Hee} and Moon, {Hyun Jin} and Park, {Yi Rang} and Ye, {Byong Duk} and Yang, {Suk Kyun} and Seo, {Geom Seog} and Jang, {Byung Ik} and Kim, {You Sun} and Kim, {Joo Sung} and Han, {Dong Soo} and Kim, {Young Ho} and Kim, {Won Ho}",
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Kim, B, Cheon, JH, Moon, HJ, Park, YR, Ye, BD, Yang, SK, Seo, GS, Jang, BI, Kim, YS, Kim, JS, Han, DS, Kim, YH & Kim, WH 2016, 'Crohn's disease prognosis and early immunomodulator therapy: Results from the CONNECT study', Journal of Gastroenterology and Hepatology (Australia), vol. 31, no. 1, pp. 126-132. https://doi.org/10.1111/jgh.13169

Crohn's disease prognosis and early immunomodulator therapy : Results from the CONNECT study. / Kim, Bun; Cheon, Jae Hee; Moon, Hyun Jin; Park, Yi Rang; Ye, Byong Duk; Yang, Suk Kyun; Seo, Geom Seog; Jang, Byung Ik; Kim, You Sun; Kim, Joo Sung; Han, Dong Soo; Kim, Young Ho; Kim, Won Ho.

In: Journal of Gastroenterology and Hepatology (Australia), Vol. 31, No. 1, 01.01.2016, p. 126-132.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Crohn's disease prognosis and early immunomodulator therapy

T2 - Results from the CONNECT study

AU - Kim, Bun

AU - Cheon, Jae Hee

AU - Moon, Hyun Jin

AU - Park, Yi Rang

AU - Ye, Byong Duk

AU - Yang, Suk Kyun

AU - Seo, Geom Seog

AU - Jang, Byung Ik

AU - Kim, You Sun

AU - Kim, Joo Sung

AU - Han, Dong Soo

AU - Kim, Young Ho

AU - Kim, Won Ho

PY - 2016/1/1

Y1 - 2016/1/1

N2 - Background: It is unknown whether the treatment initiating time of immunomodulators such as thiopurines affects the course of Crohn's disease (CD). We evaluated the efficacy of early immunomodulator therapy (EIT) on the prognosis of patients with CD. Methods: We retrospectively analyzed 1157 patients with CD who were enrolled in the CrOhn's disease cliNical NEtwork and CohorT study and received immunomodulator therapy. The patients were divided into an EIT group and a conventional therapy group based on whether immunomodulators were initiated within six months after being diagnosed with CD. We compared the rates of intestinal surgery, bowel complications, and hospitalization because of CD between the groups. Results: Patient age at diagnosis and sex were not significantly different between the two groups. The mean duration of follow-up was 105.8±51.5months. A Kaplan-Meier analysis identified that the EIT group was superior to the conventional therapy group in terms of delaying surgery (P=0.017). In multivariate analysis, EIT was an independent predicting factor associated with delaying the onset of complications (P=0.050). Patients were divided into two groups based on the year of CD diagnosis: From 1982 to 1999 (A) and from 2000 to 2008 (B). In group A, the time from diagnosis to the start of immunomodulatory therapy was longer (P<0.001), and the time to first intestinal surgery was shorter than group B (P=0.002). Conclusions: The early use of immunomodulators was associated with a good prognosis as defined by a need for surgery and the occurrence of complications in CD in our multicenter study.

AB - Background: It is unknown whether the treatment initiating time of immunomodulators such as thiopurines affects the course of Crohn's disease (CD). We evaluated the efficacy of early immunomodulator therapy (EIT) on the prognosis of patients with CD. Methods: We retrospectively analyzed 1157 patients with CD who were enrolled in the CrOhn's disease cliNical NEtwork and CohorT study and received immunomodulator therapy. The patients were divided into an EIT group and a conventional therapy group based on whether immunomodulators were initiated within six months after being diagnosed with CD. We compared the rates of intestinal surgery, bowel complications, and hospitalization because of CD between the groups. Results: Patient age at diagnosis and sex were not significantly different between the two groups. The mean duration of follow-up was 105.8±51.5months. A Kaplan-Meier analysis identified that the EIT group was superior to the conventional therapy group in terms of delaying surgery (P=0.017). In multivariate analysis, EIT was an independent predicting factor associated with delaying the onset of complications (P=0.050). Patients were divided into two groups based on the year of CD diagnosis: From 1982 to 1999 (A) and from 2000 to 2008 (B). In group A, the time from diagnosis to the start of immunomodulatory therapy was longer (P<0.001), and the time to first intestinal surgery was shorter than group B (P=0.002). Conclusions: The early use of immunomodulators was associated with a good prognosis as defined by a need for surgery and the occurrence of complications in CD in our multicenter study.

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