Sa1123 The Risk of Colorectal Cancer Following a Negative Colonoscopy: A Comparison of Different Follow-up Colonoscopy Intervals

Abstract

Background: The nationwide BioCrohn Registry (Biological Registry with Crohǹs Disease Patients in Germany) of the German Competence-Network IBD is a five-year prospective registry of patients suffering from Crohn's disease (CD) in Germany. Up to October 2012, about 1.450 patients were included by 57 different gastroenterology practices and hospitals with IBD-experience. This 24 months follow-up interim analysis reports in particular the anti-TNF data of 638 early disease CD-patients. Methods: Within the framework of this non-interventional prospective online documentation, data on the course of disease, on psychosocial disease burden, on health economics and on the genetic profile will be examined. Until the end of 2012 the registry aims at including 1.500 patients with 5 years of followup. Results: 638 early disease CD-patients (course of disease: , 3 years) were analyzed (average age: 33 years; female: 55%). The following therapies were observed. The use of immunosuppressants and/or anti-TNF increased from 74.4% (6 months), to 79.4% (12 months) and to 82.8% after two years, resp. (35.3% with anti-TNF after 24 months). Accordingly, the use of systemic glucocorticoids dropped over time (baseline until 6, 12, 18 and 24 months) from 24.9% to 8.1%, 7.9%, 5.9% and 2.5%, respectively (p ,0.001). The remission rate (PGA) was 72.4% after 12 months and 73.2% after 24 months, CRP normalized over the time (baseline: 9.2 mg/l, 24 months: 4.3 mg/l). CD-patients with an anti-TNF therapy within the first 12 months after baseline (n=88; time since first diagnosis 1.4 years) experienced a relatively favourable course by use of the anti-TNF therapy despite their complex disease (24 months: 63.3% in remission and HBI 2.5). Additionally, this subgroup showed a trend towards decreasing use of azathioprine (baseline: 31.6% and 24 months 26.7%) and a significant decrease in active smoking (32% at baseline and only 14% after 24 months). Conclusion: These 24 months real life setting follow-up data show that the group of early disease CD-patients suffer from a large burden of disease and improve considerably with the relatively early escalation of therapy as suggested by current CDguidelines in IBD-experienced centres with only minor usage of systemic glucocorticoids in the maintenance therapy. Especially the early disease CD-patients with anti-TNF-therapy show a relatively favourable course in spite of their complex disease.