PhD Scientific Days 2023

Clinical Medicine - Posters J

Declining trends of reoperations and disease behavior progression in Crohn’s disease over different therapeutic eras – a prospective population-based study from western Hungary between 1977–2020, data from the Veszprem cohort

Előadó neve

Dr. Gönczi, Lóránt

Neptun code

D1C7Z5

Előadó munkahelye

Department of Internal Medicine and Oncology, Semmelweis University

Előadó telefonszáma

+36208258690

Előadó e-mail címe

lorantgonczi@gmail.com

Az előadás címe

Declining trends of reoperations and disease behavior progression in Crohn’s disease over different therapeutic eras – a prospective population-based study from western Hungary between 1977–2020, data from the Veszprem cohort

Szerző(k) neve és munkahelye

Lorant Gonczi1, Laszlo Lakatos2, Petra Golovics3, Tunde Pandur4, Gyula David2, Zsuzsanna Erdelyi2, Istvan Szita2, Peter L. Lakatos5
1 Department of Internal Medicine and Oncology, Semmelweis University, Budapest
2 Department of Gastroenterology, Ferenc Csolnoky Hospital, Veszprem, Hungary
3 Department of Gastroenterology, Hungarian Defence Forces Medical Centre, Budapest, Hungary
4 Department of Gastroenterology, Grof Eszterhazy Hospital, Papa, Hungary
5 Division of Gastroenterology, McGill University Health Center, Montreal, Quebec, Canada

Bemutatás módja

Poszter

Szekció

Clinical Medicine - Posters J

Language of the presentation

English

Preferred session

Clinical Medicine

Összefoglaló szövege

Introduction:
Few population-based studies have investigated long-term surgery rates for Crohn’s disease (CD).
Aims:
Our aim was to analyze disease progression and surgery rates over different therapeutic eras based on the time of diagnosis; cohort-A (1977-1995), cohort-B (1996-2008), and cohort-C (2009-2018).
Methods:
946 incident CD patients were analyzed (male/female: 496/450; median age at diagnosis: 28 years(y) IQR: 22-40). Patient inclusion lasted between 1977 and 2018. Immunomodulators became widespread in Hungary from the mid-1990s, while biological therapies have been covered by the National Health Insurance Fund since 2008. Patients were followed prospectively, with both in-hospital and outpatient records reviewed regularly.
Results:
The probability of disease behavior progression from luminal (B1) disease to stenosing or penetrating phenotype (B2/B3) was significantly decreasing (27.1±SD5.3%/ 21.5±2.5%/11.3±2.2% in cohorts A/B/C after 5 years pLogRank<0.001). The probability of first resective surgery between cohorts A/B/C were 33.3±3.8%/26.5±2.1%/28.1±2.4% after 5 years; 46.1±4.1%/32.6±2.2%/33.0±2.7% after 10 years; and 59.1±4.0%/41.4±2.6% (cohorts A/B) after 20 years. There was a significant decrease in first resective surgery risk between cohorts A and B pLog Rank=0.002, however it remained similar between cohorts B and C pLog Rank=0.665. The cumulative probability of re-resection in cohorts A/B/C was decreasing over time (17.3±4.1%/12.6±2.6%/4.7±2.0% after 5 years pLog Rank=0.001).
Conclusion:
We report a gradual decline in reoperation rates and disease behavior progression in CD over time with the lowest values in the biological era. In contrast, there was no further decrease in the probability of first major resective surgery after the immunosuppressive era.
Funding:
This work was supported by the ÚNKP-22-4-II-SE-31 New National Excellence Program of the Ministry for Culture and Innovation from the Source of the National Research, Development and Innovation Fund

University and Doctoral School

Semmelweis University, Károly Rácz Doctoral School of Clinical Medicine

Supervisor

post-doctoral

Publication of my abstract

I give consent to the publication of my abstract on the website of the congress.

Kind

Szabad

Status

elfogadva

Accepted presentation method

poszter

Előadás fájl jóváhagyás

nem rendelkezett róla

Előadó

1103

Start

11:24

End

11:29

Authors (legacy)

Lorant Gonczi1, Laszlo Lakatos2, Petra Golovics3, Tunde Pandur4, Gyula David2, Zsuzsanna Erdelyi2, Istvan Szita2, Peter L. Lakatos5
1 Department of Internal Medicine and Oncology, Semmelweis University, Budapest
2 Department of Gastroenterology, Ferenc Csolnoky Hospital, Veszprem, Hungary
3 Department of Gastroenterology, Hungarian Defence Forces Medical Centre, Budapest, Hungary
4 Department of Gastroenterology, Grof Eszterhazy Hospital, Papa, Hungary
5 Division of Gastroenterology, McGill University Health Center, Montreal, Quebec, Canada