Intest Res.  2014 Oct;12(4):281-286. 10.5217/ir.2014.12.4.281.

Long-Term Clinical Outcomes of Korean Patient With Crohn's Disease Following Early Use of Infliximab

• Kim NH
• Jung YS
• Moon CM
• Lee SY
• Kim ER
• Kim YH
• Lee CK
• Lee SH
• Kim JH
• Huh KC
• Yoon SM
• Song HJ
• Boo SJ
• Jang HJ
• Kim YS
• Lee KM
• Shin JE
• Park DI

• KMID: 2174404
• DOI: http://doi.org/10.5217/ir.2014.12.4.281

Abstract

BACKGROUND/AIMS
Several recent studies have reported that the early use of infliximab (IFX) improves the prognosis of Crohn's disease (CD). However, no data are available from Asian populations, as the forementioned studies have all been conducted in Western countries. The aim of the current study was to evaluate the impact of early use of IFX on the prognosis of Korean patients with CD.
METHODS
Patients with a diagnosis of CD established between July 1987 and January 2012 were investigated in 12 university hospitals in Korea. Because insurance coverage for IFX treatment began in August 2005, patients were assigned to either of 2 groups based on diagnosis date. The first group included patients diagnosed from July 1987 to December 2005, and the second from January 2006 to January 2012. We compared the cumulative probabilities of operation and reoperation between the two groups using the Kaplan-Meier method and a log-rank test.
RESULTS
Of the 721 patients investigated, 443 (61.4%) comprized the second group. Although the cumulative probabilities of immunosuppressant (P<0.001) and IFX use (P<0.001) after diagnosis were significantly higher in the second group, there were no significant differences in cumulative probabilities of operation (P=0.905) or reoperation (P=0.418) between two groups.
CONCLUSIONS
The early use of IFX did not reduce CD-related surgery requirements in Korean patients with CD. These study results suggest that the early use of IFX may have little impact on the clinical outcome of CD in Korean patients in the setting of a conventional step-up algorithm.

Keyword

Crohn disease; Infliximab; Prognosis

MeSH Terms

Asian Continental Ancestry Group
Crohn Disease*
Diagnosis
Hospitals, University
Humans
Infliximab
Insurance Coverage
Korea
Prognosis
Reoperation

Figure

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  Fig. 1 Cumulative probability of infliximab (IFX) use during follow-up.

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  Fig. 2 Cumulative probability of azathioprine (AZA) use during follow-up.

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  Fig. 3 Cumulative probability of operation during follow-up.

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  Fig. 4 Cumulative probability of re-operation during follow-up.

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