PhD Scientific Days 2022

Clinical Medicine V. (Poster discussion will take place in the Aula during the Coffee Break)

Incidence, prevalence, disease course and treatment strategy of Crohn’s disease patients in Western Hungary – a population-based inception cohort study between 2007 and 2018, data from the Veszprem County cohort

Text of the abstract

Background:
The number of prospective population-based studies of Crohn’s disease(CD) patients is still limited from Eastern Europe. The present study is a continuation of the Veszprem IBD cohort with a follow-up since 1977.
Aim:
Our aim was to analyze the incidence and prevalence rates, disease phenotype at diagnosis, treatment strategy, disease course and surgical outcomes in a prospective population-based study including incident CD patients diagnosed between 2007 and 2018.
Methods:
Data of 421 patients were analyzed (male/female: 237/184; mean age at diagnosis: 33.3±16.2 years). Both in-hospital and outpatient records were collected and comprehensively reviewed. The source of age- and gender-specific demographic data was derived from the Hungarian Central Statistical Office.
Results:
Adjusted mean incidence rate was 9.94 (CI95%: 9.0-10.9) /105 person-years in this 12 year period. Prevalence rate was 236.78 (CI95%: 220.8-252.8) in 2015. Stenosing (B2) or penetrating (B3) disease behavior was present in 17.6% and 20.0% of the patients at diagnosis, while perianal disease in 13.5%. The probability of disease behavior progression from luminal into stenosing or penetrating phenotype was 12.2% (SE:2.0) at 3 years and 22.0% (SE:3.0) at 10 years. Distribution of maximal therapeutic steps during the total follow-up (8.53y, SD: 3.3) were 5-ASA in 15.7%, systemic corticosteroids in 14.3%, immunosuppressive therapy in 42.5%; biologic therapy in 26.2%. The Probability of receiving biological therapy after diagnosis was 20.9% (SE:2.0) at 5 years and 28.8% (SE:2.0) at 10 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.
Conclusions:
The incidence of CD in this period was high, similar to high-incidence areas in Western Europe and to our previous data from the Veszprem cohort. Distribution of maximal treatment steps is in line with the biological era. Disease behavior progression was lower compared to data from previous decades, while long-term (10y) surgery rates also decreased.
Fundung: post-doctorial ÚNKP-21-4-II-SE-31