Abstract
BackgroundThis study aimed to understand the disease characteristics and treatment outcomes of Crohn’s disease (CD) in a real-world setting in China.MethodsIn this prospective, non-interventional, multicenter disease registry, adults (≥18 years) with existing and newly diagnosed CD were recruited from 14 medical centers across China from January 2015 to January 2017. The study consisted of the enrollment and follow-up periods, of 12 months each. Demographic, clinical characteristics, diagnostic duration and management of CD at enrollment were evaluated. Logistic regression analysis and stepwise multivariate logistic regression analysis used to assess the relationship between the risk factors and CD.ResultsOf 504 enrolled patients, 499 (99.0%) were eligible for analysis. The mean (SD) age at study enrollment was 32.3 (11.43) years and the majority (69.7%) of participants were male. In the past 15 years, a sustained decrease of the period of time in the diagnosis of CD was observed, at about 39.4 (24.11) months in 2010, which decreased to 3.1 (2.13) months in 2015. The most common presenting symptoms of CD included abdominal pain (78.0%), diarrhea (58.1%), weight loss (52.9%) and fever (30.1%). Oral ulcer (19.4%) and arthritis (9.8%) were the most common extra-intestinal manifestations. Non-stricturing non-penetrating (B1) (49.9%) behavior and ileocolonic involvement (L3) (56.2%) location were more frequent. Perianal disease was observed in 29.1% of the patients. Around 23.8% (119/499) patients had CD-related surgery other than perianal disease surgery. Older age at enrollment, longer disease course, complicated disease behavior and absence of perianal disease were all surgery risk factors (p < 0.05). The most common medications was immunomodulators (e.g., azathioprine) (41.5%), anti-TNFα agents (32.9%) and aminosalicylates (20.6%). The mean (SD) Crohn’s Disease Active Index (CDAI) score was 159.1 (91.45) and almost half of the patients (49.1%, 81/165) were in remission.ConclusionsThis study demonstrated the CD-disease characteristics, risk factors of CD-related surgery and perianal disease, and treatment strategies in a real-world setting in China and may help in developing programs to diagnose and manage patients with CD.
Highlights
This study aimed to understand the disease characteristics and treatment outcomes of Crohn’s disease (CD) in a real-world setting in China. 16Johnson & Johnson (China)
While CD is well known in Western countries, it was reported in China about 30 years later: the first case of CD was reported in China in 1956 [8]
Patents enrolled in inland medical centers had a higher proportion of smoking and drinking than that of patients enrolled in coastal cities (Table 1)
Summary
This study aimed to understand the disease characteristics and treatment outcomes of Crohn’s disease (CD) in a real-world setting in China. The incidence rate of CD in Western countries has demonstrated a significant increasing trend, and it varies from 0.3 to 12.7 cases per 100,000 persons in Europe and 0 to 20.2 cases per 100,000 persons in North America [2, 3]. While CD is well known in Western countries, it was reported in China about 30 years later: the first case of CD was reported in China in 1956 [8]. The overall incidence of CD in China is much lower than in Western countries, the incidence is increasing rapidly with urbanization and socioeconomic development [9]. Since most studies focused only on particular regions of China, existing data are inadequate to represent the actual incidence of CD at the national level
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