Long-term clinical outcomes of Crohn's disease and intestinal Behcet's disease
Yoon Suk Jung1, Jae Hee Cheon, Soo Jung Park
1Department of Internal Medicine and Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea.
Insights
Crohn's disease (CD) and intestinal Behcet's disease (BD) share similar long-term prognoses and surgical outcomes. However, CD patients more frequently require corticosteroid or immunosuppressant therapies compared to intestinal BD patients.
Area of Science:
- Gastroenterology
- Internal Medicine
- Inflammatory Bowel Disease
Background:
- Crohn's disease (CD) and intestinal Behcet's disease (BD) are chronic transmural inflammatory conditions.
- Both diseases exhibit relapsing-remitting courses often necessitating surgical intervention.
- Direct long-term comparative prognoses between CD and intestinal BD remain understudied.
Purpose of the Study:
- To directly compare the long-term clinical outcomes and postoperative prognoses of Crohn's disease and intestinal Behcet's disease.
- To evaluate differences in disease management, including medication use and reoperation rates.
Main Methods:
- Retrospective review of medical records for 332 CD patients and 276 intestinal BD patients.
- Follow-up conducted at a single tertiary academic medical center in Korea from March 1986 to July 2010.
- Kaplan-Meier method and log-rank test were employed for clinical outcome analysis post-diagnosis and surgery.
Main Results:
- No significant differences were found in the cumulative probabilities of surgery or hospital admission between CD and intestinal BD.
- Postoperative clinical recurrence and reoperation rates did not differ significantly between the two diseases.
- CD patients demonstrated significantly higher cumulative probabilities of corticosteroid and immunosuppressant use compared to intestinal BD patients.
Conclusions:
- Long-term clinical outcomes and postoperative prognoses are comparable between Crohn's disease and intestinal Behcet's disease.
- Crohn's disease management involves more frequent reliance on corticosteroid or immunosuppressant therapies than intestinal Behcet's disease.
Background:
Crohn's disease (CD) and intestinal Behcet's disease (BD) are transmural inflammatory diseases with fluctuating courses characterized by repeated episodes of relapse and remission that often require operation or reoperation. However, no study has directly compared the long-term prognoses of these two diseases.
Methods:
We reviewed the medical records of 332 patients with CD and 276 patients with intestinal BD who were regularly followed up at a single tertiary academic medical center in Korea between March 1986 and July 2010. The clinical outcomes after diagnosis and surgery were analyzed using the Kaplan-Meier method and log-rank test.
Results:
There were no significant differences in the cumulative probabilities of surgery (29.4% and 36.0% vs. 31.6% and 44.4% at 5 and 10 years, respectively: P = 0.287) or admission (66.1% and 73.8% vs. 59.0% and 69.2%, P = 0.259) between CD and intestinal BD. Furthermore, no differences were observed between the two diseases for the cumulative probabilities of postoperative clinical recurrence (P = 0.724) and reoperation (P = 0.770). However, the cumulative probabilities of corticosteroid use (63.8% and 76.6% vs. 42.6% and 59.4% at 5 and 10 years, respectively: P < 0.001) and immunosuppressant use (49.1% and 65.5% vs. 27.1% and 37.7%, P < 0.001) were significantly higher in CD patients than in intestinal BD patients.
Conclusions:
There were no significant differences in the long-term clinical outcomes and postoperative prognoses between CD and intestinal BD, although CD patients required corticosteroid or immunosuppressant therapy more often than intestinal BD patients.
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