5-Aminosalicylic Acid Prevents Disease Behavior Progression and Intestinal Resection in Colonic and Ileocolonic Crohn’s Disease Patients: A Retrospective Study

Jian Wan,Shuang Han,Yujie Zhang,Xianmin Xue,Zhenzhen Liu,Xuan Wang,Jie Liang,Min Chen,Kaichun Wu,Yan Nie,Yongquan Shi,Yani Li,Rafał Filip

doi:10.1155/2021/1412663

Abstract

Background and Aims The efficacy of 5-aminosalicylic acid (5-ASA) in the long-term outcome of Crohn's disease (CD) patients was uncertain. This study aimed to evaluate the efficacy of the 5-ASA in preventing disease behavior progression and intestinal resection in CD patients. Methods CD patients were prospectively enrolled from January 2008 to September 2019 in Xijing Hospital. Disease behavior progression was defined as the development of stricturing (B2) or penetrating disease (B3) in patients with nonstricturing/nonpenetrating disease (B1) at diagnosis. Cox regression analyses were used to investigate the associations between disease location progression, disease behavior progression, and intestinal resection and multiple covariates. Results In total, 122 CD patients were followed up for 4.3 years. At the time of diagnosis, disease location was ileal in 19.7% (24/122), colonic in 41.0% (50/122), and ileocolonic in 39.3% (48/122). A total of 87 (71.3%) patients had B1 at diagnosis. The disease behavior progression and intestinal resection rates were 42.5% (37/87) and 29.5% (36/122). The use of 5-ASA reduced the risk of disease behavior progression (HR 0.30, 95% CI 0.14–0.61, P = 0.001) and intestinal resection (HR 0.33, 95% CI 0.17–0.90, P = 0.027) in colonic and ileocolonic CD patients. Patients who presented with ileal disease at diagnosis did not have the same protective effects when taking 5-ASA (P > 0.05). Conclusions The use of 5-ASA could improve the long-term outcome of CD patients with colon involvement. The result emphasized the importance of early use of 5-ASA in the daily management of colonic involved CD.

Highlights

Crohn’s disease (CD) is an inflammatory bowel disease (IBD) that may involve the whole gastrointestinal tract [1].e incidence of CD has increased sharply in China [1, 2]
We aimed to evaluate the use of the 5-aminosalicylic acid (5-ASA) in reducing the risk of disease progression and surgery in CD patients, especially in the colon involved patients
Study Population and the Endpoint of Study. e CD patients who were diagnosed in the Department of Digestive Disease, Xijing Hospital, and followed up at the specialist clinic for IBD from January 2008 to September 2019 were prospectively recruited into a database. e staffs of the IBD clinic include experienced gastroenterologists, gastrointestinal specialist pathologists, radiologists, nurses, specialist surgeons, and nutritionists

Summary

Introduction

Crohn’s disease (CD) is an inflammatory bowel disease (IBD) that may involve the whole gastrointestinal tract [1].e incidence of CD has increased sharply in China [1, 2]. Population-based studies demonstrate that disease location is relatively stable in CD patients and is presented with ileal, ileocolonic, or colonic disease in about one-third each [3]. A multicenter prospective disease registry study in China demonstrates that more than half of the CD patients were presented with ileocolonic disease at diagnosis and the rates of ileal and colonic disease were 27.8% and 14.4% [5]. Cumulative risk of developing stricturing or penetrating disease among those patients with inflammatory behavior is 18% at 7 years [6] and 51% at 20 years [7] after diagnosis. Is study aimed to evaluate the efficacy of the 5-ASA in preventing disease behavior progression and intestinal resection in CD patients. A total of 87 (71.3%) patients had B1 at diagnosis

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