Gonczi Lorant, Lakatos Laszlo, Kurti Zsuzsanna, Golovics Petra A, Pandur Tunde, David Gyula, Erdelyi Zsuzsanna, Szita Istvan, Lakatos Peter L
Department of Internal Medicine and Oncology, Semmelweis University, Budapest, Hungary.
Department of Gastroenterology, Ferenc Csolnoky Hospital, Veszprem, Hungary.
J Crohns Colitis. 2023 Mar 18;17(2):240-248. doi: 10.1093/ecco-jcc/jjac132.
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 analyse 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.
A total of 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 were derived from the Hungarian Central Statistical Office.
Mean incidence rate was 9.9 [95% CI: 9.0-10.9]/105 person-years in this 12-year period. Prevalence rate was 236.8 [95% CI: 220.8-252.8] in 2015; 17.6% and 20.0% of the patients had stenosing[B2] and penetrating[B3] disease behavior at diagnosis,respectively. The probability of disease behaviour progression from luminal to B2/B3 phenotype was 14.7% (standard error [SE]: 2.2) at 5 years after diagnosis. Distribution of maximal therapeutic steps during the total follow-up (8.5 years [8.5y], standard deviation [SD]: 3.3) was 5-aminosalicylic acid [5-ASA] in 15.7%, corticosteroids in 14.3%, immunosuppressives in 42.5%, and biologic therapy in 26.2%. The probability of receiving biologictherapy 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. The perianal surgery rate was 31.3% among patients with perianal involvement.
The incidence of CD in Hungary was high, similar to high-incidence areas in Western Europe. Treatment strategies are reflecting the biologic era. Disease behaviour progression was lower, as well as long-term [10y] surgery rates decreasing compared with data from previous decades.
来自东欧的基于人群的克罗恩病（CD）前瞻性研究数量仍然有限。本研究是维斯普雷姆炎症性肠病队列研究的延续。我们的目的是分析一个基于人群的前瞻性起始队列中的发病率、患病率、疾病表型、治疗策略、疾病进程和手术结局，该队列纳入了2007年至2018年期间诊断为CD的患者。
共纳入421例连续的起始患者[男/女：237/184；诊断时的平均年龄：33.3±16.2岁]。收集并全面审查了住院和门诊记录。人口统计学数据来自匈牙利中央统计局。
在这12年期间，平均发病率为9.9[95%置信区间：9.0 - 10.9]/10万人年。2015年的患病率为236.8[95%置信区间：220.8 - 252.8]；17.6%和20.0%的患者在诊断时分别具有狭窄型（B2）和穿透型（B3）疾病行为。诊断后5年，疾病行为从肠腔型进展为B2/B3表型的概率为14.7%（标准误[SE]：2.2）。在整个随访期间（8.5年[8.5y]，标准差[SD]：3.3），最大治疗步骤的分布为：5-氨基水杨酸（5-ASA）占15.7%，皮质类固醇占14.3%，免疫抑制剂占42.5%，生物治疗占26.2%。诊断后5年接受生物治疗的概率为20.9%[SE：2.0]。首次切除手术的概率在1年时为20.7%[SE：2.0]，5年时为26.1%[SE：2.
