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News

Predicting complicated Crohn's disease and surgery

The recent issue of the Alimentary Pharmacology & Therapeutics investigates phenotypes, genetics, serology and psychological characteristics to identify predictors of complication Crohn's.

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Predictors of complicated Crohn's disease, defined as stricturing or penetrating behavior, and surgery have largely been derived from referral center populations.

Dr Ryan and colleagues from Canada investigated whether serological markers, susceptibility genes or psychological characteristics are associated with complicated Crohn's disease or surgery in a population-based cohort.

The research team evaluated 182 members of the Manitoba IBD Cohort with Crohn's disease phenotyped using the Montreal classification underwent genetic and serological analysis at enrolment, and after 5 years.

The team reported that 127 patients had paired sera at baseline, and 5 years later, and their data were used to predict outcomes at a median of 9 years.

Serological analysis consisted of a 7 antibody panel, and DNA was tested for Crohn's disease-associated NOD2 variants, ATG16L1 and IL23R.

The research team investigated that psychological characteristics were assessed using semi-structured interviews and validated survey measures.

65% had complicated Crohn's disease
Alimentary Pharmacology & Therapeutics

The team noted that 65% had complicated Crohn's disease, and 42% underwent surgery.

The researchers found that only ASCA IgG-positive serology was predictive of stricturing/penetrating behaviour and ileal Crohn's disease.

Complicated Crohn's disease behavior was strongly associated with surgery, whereas in multivariate analysis, only ASCA IgG was associated.

ASCA titre results were similar at baseline and follow-up.

The team observed that psychological characteristics were not significantly associated with disease behaviour, serological profile or genotype.

Dr Ryan;s team concludes, "ASCA IgG at baseline was significantly associated with stricturing/penetrating disease at 910 years from diagnosis."

"Stricturing/penetrating disease was significantly associated with surgery."

"In a model including serology, the genotypes assessed did not significantly associate with complicated disease or surgery."

Alimentary Pharmacol Ther 2013: 38(3) 274283
25 July 2013

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