Abstract
Abstract Background Crohn’s disease (CD) is a chronic and progressive condition with a growing global prevalence, leading to potential bowel damage and disability. Data on the clinical presentation, outcomes, and treatment options in newly diagnosed CD patients in Europe in the current era are essential to guide physicians. The aim is describe the clinical characteristics of a contemporary European cohort of recently diagnosed CD patients. Methods The Crohn's Disease Cohort (CROCO) is an ongoing, multicenter, European prospective study of CD patients diagnosed within the last 12 months, aimed at tracking bowel damage progression and disability. This report presents the baseline characteristics at study inclusion. Results From August 2021 to October 2024, 399 patients (56% male, 46% current or former smokers) with a median age at diagnosis of 33.7 years (IQR 24.6; 49.2) were recruited across 18 centers. The median delay between symptom onset and diagnosis was 6.2 months (IQR 2; 15.4), and the median disease duration at inclusion was 3.8 months (IQR 1.6; 7.4). Ileal involvement (L1/L3) was reported in 85% of patients. Overall, 15% had perianal disease and 28% had extraintestinal manifestations, predominantly arthritis/arthralgia. Complicated disease behavior was observed in 32% of patients at diagnosis (stricturing: 17%; penetrating: 15%); 6% had undergone intestinal surgery, and 3% perianal surgery from diagnosis to inclusion. CD-related hospitalizations were reported by 22% of patients. Regarding treatments, 51% received steroids (28% systemic steroids), 17% 5-ASA, 1% immunosuppressants monotherapy, and 44% initiated biological therapy (168 anti-TNF, 8 anti-IL 12/23, and 6 anti-integrin, representing 42%, 2% and 2% of the cohort, respectively). A total of 31% were managed with a combination of biologic and immunosuppressant therapies. Disability assessment showed that 48% of patients reported no disability, 24% mild disability, and 28% moderate to severe disability. Conclusion In this prospective European cohort of newly diagnosed CD patients, nearly one-third had a complicated disease phenotype and moderate to severe disability, despite a relatively short diagnostic delay. While steroid use remains common, early initiation of biological therapy in 44% of patients reflects a shift in CD management strategies.
Published Version
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