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Long-term Disease Course of Crohn’s Disease: Changes in Disease Location, Phenotype, Activities, and Predictive Factors

이창균|문성경|유명원|Oh Chi Hyuk|Cho Choong Wui
거트앤리버 소화기연관학회협의회|2022.03|Gut and Liver|제16권 제2호|pp. 157-170|DOI 10.5009/gnl210118

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키워드

Inflammatory bowel diseaseCrohn diseaseRecurrencePrognosisDisease course

초록

Crohn’s disease (CD) is a chronic destructive inflammatory bowel disease that affects young people and is associated with significant morbidity. The clinical spectrum and disease course of CD are heterogeneous and often difficult to predict based on the initial presentation. In this article, changes in the disease location, behavior, clinical course during long-term follow-up, and predictive factors are reviewed. Generally, four different patterns of clinical course are discussed: remission, stable disease, chronic relapsing disease, and chronic refractory disease. Understanding the long-term disease course of CD is mandatory to reveal the underlying pathophysiology of the disease and to move toward a more optimistic disease course, such as remission or stability, and less adverse outcomes or devastating sequelae.

Abstract

Crohn’s disease (CD) is a chronic destructive inflammatory bowel disease that affects young people and is associated with significant morbidity. The clinical spectrum and disease course of CD are heterogeneous and often difficult to predict based on the initial presentation. In this article, changes in the disease location, behavior, clinical course during long-term follow-up, and predictive factors are reviewed. Generally, four different patterns of clinical course are discussed: remission, stable disease, chronic relapsing disease, and chronic refractory disease. Understanding the long-term disease course of CD is mandatory to reveal the underlying pathophysiology of the disease and to move toward a more optimistic disease course, such as remission or stability, and less adverse outcomes or devastating sequelae.

참고문헌 (98)

  1. Aniwan S, "Epidemiology, natural history, and risk stratification of Crohn’s disease", Gastroenterol Clin North Am, 46, pp.463~480 (2017)
  2. Ng SC, "Incidence and phenotype of inflammatory bowel disease based on results from the Asia-Pacific Crohn’s and Colitis Epidemiology Study", Gastroenterology, 145, pp.158~165 (2013)
  3. Pariente B, "Development of the Crohn’s disease digestive damage score, the Lémann score", Inflamm Bowel Dis, 17, pp.1415~1422 (2011)
  4. Targan SR, "A short-term study of chimeric monoclonal antibody cA2 to tumor necrosis factor alpha for Crohn’s disease. Crohn’s Disease cA2Study Group", N Engl J Med, 337, pp.1029~1035 (1997)
  5. Ben-Horin S, "Review article : loss of response to anti-TNF treatments in Crohn’s disease", Aliment Pharmacol Ther, 33, pp.987~995 (2011)
  6. Solberg IC, "Clinical course in Crohn’s disease : results of a Norwegian population-based ten-year follow-up study", Clin Gastroenterol Hepatol, 5, pp.1430~1438 (2007)
  7. Tarrant KM, "Perianal disease predicts changes in Crohn’s disease phenotyperesults of a population-based study of inflammatory bowel disease phenotype", Am J Gastroenterol, 103, pp.3082~3093 (2008)
  8. Kalaria R, "Temporal change in phenotypic behaviour in patients with Crohn’s disease : do Indian patients behave differently from Western and other Asian patients", J Crohns Colitis, 10, pp.255~261 (2016)
  9. Lakatos PL, "Perianal disease, small bowel disease, smoking, prior steroid or early azathioprine", biological therapy are predictors of disease behavior change in patients with Crohn’s disease, 2009, pp.15, 3504~3510
  10. Makharia GK, "Survey of inflammatory bowel diseases in India", Indian J Gastroenterol, 31, pp.299~306 (2012)
  11. Ye BD, "Clinical features and longterm prognosis of Crohn’s disease in Korea", Scand J Gastroenterol, 45, pp.1178~1185 (2010)
  12. Chow DK, "Changes in Crohn's disease phenotype over time in the Chinese population : validation of the Montreal classification system", Inflamm Bowel Dis, 14, pp.536~541 (2008)
  13. Louis E, "Behaviour of Crohn’s disease according to the Vienna classification : changing pattern over the course of the disease", Gut, 49, pp.777~782 (2001)
  14. Thia KT, "Risk factors associated with progression to intestinal complications of Crohn’s disease in a population-based cohort", Gastroenterology, 139, pp.1147~1155 (2010)
  15. Katsuhiro Arai, "Phenotypic characteristics of pediatric inflammatory bowel disease in Japan: results from a multicenter registry", Intestinal research, 18(4), pp.412~420 (2020), 대한장연구학회[DOI]
  16. Lo B, "Changes in disease behaviour and location in patients with Crohn’s disease after seven years of follow-up : a Danish population-based inception cohort", J Crohns Colitis, 12, pp.265~272 (2018)
  17. Cuthbert AP, "The contribution of NOD2 gene mutations to the risk and site of disease in inflammatory bowel disease", Gastroenterology, 122, pp.867~874 (2002)
  18. Newman B, "CARD15 and HLA DRB1 alleles influence susceptibility and disease localization in Crohn’s disease", Am J Gastroenterol, 99, pp.306~315 (2004)
  19. Bayless TM, "Crohn’s disease : concordance for site and clinical type in affected family members. Potential hereditary influences", Gastroenterology, 111, pp.573~579 (1996)
  20. Cosnes J, "Long-term evolution of disease behavior of Crohn’s disease", Inflamm Bowel Dis, 8, pp.244~250 (2002)
  21. Beaugerie L, "Predictors of Crohn’s disease", Gastroenterology, 130, pp.650~656 (2006)
  22. Loly C, "Predictors of severe Crohn’s disease", Scand J Gastroenterol, 43, pp.948~954 (2008)
  23. Henriksen M, "Clinical course in Crohn’s disease : results of a five-year population-based follow-up study(the IBSEN study)", Scand J Gastroenterol, 42, pp.602~610 (2007)
  24. Rönnblom A, "Clinical course of Crohn’s disease in a population-based cohort in Uppsala County followed for 10 years", Scand J Gastroenterol, 55, pp.1301~1307 (2020)
  25. Das K, "Crohn’s disease in India : a multicenter study from a country where tuberculosis is endemic", Dig Dis Sci, 54, pp.1099~1107 (2009)
  26. Binder V, "Prognosis in Crohn’s disease : based on results from a regional patient group from the county of Copenhagen", Gut, 26, pp.146~150 (1985)
  27. Gajendran M, "A comprehensive review and update on Crohn’s disease", Dis Mon, 64, pp.20~57 (2018)
  28. Lichtenstein GR, "Management of Crohn’s disease in adults", Am J Gastroenterol, 104, pp.465~483 (2009)
  29. Silverstein MD, "Clinical course and costs of care for Crohn’s disease : Markov model analysis of a population-based cohort", Gastroenterology, 117, pp.49~57 (1999)
  30. Peyrin-Biroulet L, "Impact of azathioprine and tumour necrosis factor antagonists on the need for surgery in newly diagnosed Crohn’s disease", Gut, 60, pp.930~936 (2011)
  31. Colombel JF, "Infliximab, azathioprine, or combination therapy for Crohn’s disease", N Engl J Med, 362, pp.1383~1395 (2010)
  32. Feagan B, "A randomized trial of methotrexate in combination with infliximab for the treatment of Crohn’s disease", Gastroenterology, 135, pp.294~295 (2008)
  33. Lémann M, "Infliximab plus azathioprine for steroid-dependent Crohn’s disease patients : a randomized placebo-controlled trial", Gastroenterology, 130, pp.1054~1061 (2006)
  34. D’Haens G, "Early combined immunosuppression or conventional management in patients with newly diagnosed Crohn’s disease : an open randomised trial", Lancet, 371, pp.660~667 (2008)
  35. Peyrin-Biroulet L, "Selecting Therapeutic Targets in Inflammatory Bowel Disease(STRIDE) : determining therapeutic goals for treat-to-target", Am J Gastroenterol, 110, pp.1324~1338 (2015)
  36. Rutgeerts P, "Adalimumab induces and maintains mucosal healing in patients with Crohn’s disease : data from the EXTEND trial", Gastroenterology, 142, pp.1102~1111 (2012)
  37. Schnitzler F, "Mucosal healing predicts long-term outcome of maintenance therapy with infliximab in Crohn’s disease", Inflamm Bowel Dis, 15, pp.1295~1301 (2009)
  38. Turner D, "STRIDE-II : an update on the Selecting Therapeutic Targets in Inflammatory Bowel Disease(STRIDE)initiative of the International Organization for the Study of IBD(IOIBD) : determining therapeutic goals for treat-to-target strategies in IBD", Gastroenterology, 160, pp.1570~1583 (2021)
  39. Colombel JF, "Adalimumab induces deep remission in patients with Crohn’s disease", Clin Gastroenterol Hepatol, 12, pp.414~422 (2014)
  40. Colombel JF, "Randomised clinical trial : deep remission in biologic and immunomodulator naïve patients with Crohn’s disease. A SONIC post hoc analysis", Aliment Pharmacol Ther, 41, pp.734~746 (2015)
  41. Latella G, "Clinical course of Crohn’s disease first diagnosed at surgery for acute abdomen", Dig Liver Dis, 41, pp.269~276 (2009)
  42. Vegh Z, "Can we predict disease course with clinical factors", Curr Drug Targets, 19, pp.791~797 (2018)
  43. Jess T, "Changes in clinical characteristics, course, and prognosis of inflammatory bowel disease during the last 5 decades : a population-based study from Copenhagen, Denmark", Inflamm Bowel Dis, 13, pp.481~489 (2007)
  44. Oussalah A, "A multicenter experience with infliximab for ulcerative colitis : outcomes and predictors of response, optimization, colectomy, and hospitalization", Am J Gastroenterol, 105, pp.2617~2625 (2010)
  45. Rungoe C, "Changes in medical treatment and surgery rates in inflammatory bowel disease : a nationwide cohort study 1979-2011", Gut, 63, pp.1607~1616 (2014)
  46. 김덕환, "Clinical Outcomes and Predictive Factors for Response after the First Course of Corticosteroid Therapy in Patients with Crohn’s Disease", Gut and Liver, 7(1), pp.58~65 (2013), 거트앤리버 소화기연관학회협의회
  47. D’Arcangelo G, "Predictors of longterm clinical and endoscopic remission in children with Crohn disease treated with infliximab", J Pediatr Gastroenterol Nutr, 68, pp.841~846 (2019)
  48. Riordan AM, "Treatment of active Crohn’s disease by exclusion diet : East Anglian multicentre controlled trial", Lancet, 342, pp.1131~1134 (1993)
  49. Jones VA, "Crohn’s disease : maintenance of remission by diet", Lancet, 2, pp.177~180 (1985)
  50. Gomollón F, "3rd European evidence-based consensus on the diagnosis and management of Crohn’s disease 2016 : part 1. Diagnosis and medical management", J Crohns Colitis, 11, pp.3~25 (2017)
  51. Wintjens D, "Disease activity patterns of Crohn’s disease in the first ten years after diagnosis in the population-based IBD South Limburg cohort", J Crohns Colitis, 15, pp.391~400 (2021)
  52. Jones J, "Relationships between disease activity and serum and fecal biomarkers in patients with Crohn’s disease", Clin Gastroenterol Hepatol, 6, pp.1218~1224 (2008)
  53. Kenji Watanabe, "Clinical management for small bowel of Crohn’s disease in the treat-to-target era: now is the time to optimize treatment based on the dominant lesion", Intestinal research, 18(4), pp.347~354 (2020), 대한장연구학회[DOI]
  54. Oberhuber G, "Significant association of strictures and internal fistula formation in Crohn’s disease", Virchows Arch, 437, pp.293~297 (2000)
  55. Benitez JM, "Role of endoscopy, cross-sectional imaging and biomarkers in Crohn’s disease monitoring", Gut, 62, pp.1806~1816 (2013)
  56. Hansel SL, "Clinical benefit of capsule endoscopy in Crohn’s disease : impact on patient management and prevalence of proximal small bowel involvement", Inflamm Bowel Dis, 24, pp.1582~1588 (2018)
  57. Cheifetz AS, "The risk of retention of the capsule endoscope in patients with known or suspected Crohn’s disease", Am J Gastroenterol, 101, pp.2218~2222 (2006)
  58. Cosnes J, "Epidemiology and natural history of inflammatory bowel diseases", Gastroenterology, 140, pp.1785~1794 (2011)
  59. Stange EF, "European evidence based consensus on the diagnosis and management of Crohn’s disease : definitions and diagnosis", Gut, 55(Suppl 1), pp.i1~i15 (2006)
  60. Liverani E, "How to predict clinical relapse in inflammatory bowel disease patients", World J Gastroenterol, 22, pp.1017~1033 (2016)
  61. D’Incà R, "Can calprotectin predict relapse risk in inflammatory bowel disease", Am J Gastroenterol, 103, pp.2007~2014 (2008)
  62. Tibble JA, "Surrogate markers of intestinal inflammation are predictive of relapse in patients with inflammatory bowel disease", Gastroenterology, 119, pp.15~22 (2000)
  63. García-Sánchez V, "Does fecal calprotectin predict relapse in patients with Crohn’s disease and ulcerative colitis", J Crohns Colitis, 4, pp.144~152 (2010)
  64. Naismith GD, "A prospective evaluation of the predictive value of faecal calprotectin in quiescent Crohn’s disease", J Crohns Colitis, 8, pp.1022~1029 (2014)
  65. Laharie D, "Prediction of Crohn’s disease relapse with faecal calprotectin in infliximab responders : a prospective study", Aliment Pharmacol Ther, 34, pp.462~469 (2011)
  66. Hanauer SB, "Maintenance infliximab for Crohn’s disease : the ACCENT I randomised trial", Lancet, 359, pp.1541~1549 (2002)
  67. Roblin X, "Addition of azathioprine to the switch of anti-TNF in patients with IBD in clinical relapse with undetectable anti-TNF trough levels and antidrug antibodies : a prospective randomised trial", Gut, 69, pp.1206~1212 (2020)
  68. Sandborn WJ, "Dosage adjustment during long-term adalimumab treatment for Crohn’s disease : clinical efficacy and pharmacoeconomics", Inflamm Bowel Dis, 17, pp.141~151 (2011)
  69. Schnitzler F, "Long-term outcome of treatment with infliximab in 614 patients with Crohn’s disease : results from a single-centre cohort", Gut, 58, pp.492~500 (2009)
  70. Gisbert JP, "Loss of response and requirement of infliximab dose intensification in Crohn’s disease : a review", Am J Gastroenterol, 104, pp.760~767 (2009)
  71. Bendtzen K, "Individualized monitoring of drug bioavailability and immunogenicity in rheumatoid arthritis patients treated with the tumor necrosis factor alpha inhibitor infliximab", Arthritis Rheum, 54, pp.3782~3789 (2006)
  72. Allez M, "The efficacy and safety of a third anti-TNF monoclonal antibody in Crohn’s disease after failure of two other anti-TNF antibodies", Aliment Pharmacol Ther, 31, pp.92~101 (2010)
  73. Ben-Horin S, "Loss of response to anti-tumor necrosis factors : what is the next step", Dig Dis, 32, pp.384~388 (2014)
  74. Sahmoud T, "Identifying patients with a high risk of relapse in quiescent Crohn’s disease. The GETAID Group. The Groupe d’Etudes Thérapeutiques des Affections Inflammatoires Digestives", Gut, 37, pp.811~818 (1995)
  75. Timmer A, "Oral contraceptive use and smoking are risk factors for relapse in Crohn’s disease. The Canadian Mesalamine for Remission of Crohn’s Disease Study Group", Gastroenterology, 114, pp.1143~1150 (1998)
  76. Bitton A, "Predicting relapse in Crohn’s disease : a biopsychosocial model", Gut, 57, pp.1386~1392 (2008)
  77. in inflammatory bowel disease, "J Crohns Colitis", 2018, 17~31
  78. Amre DK, "Investigating the hygiene hypothesis as a risk factor in pediatric onset Crohn’s disease : a case-control study", Am J Gastroenterol, 101, pp.1005~1011 (2006)
  79. Munkholm P, "Disease activity courses in a regional cohort of Crohn’s disease patients", Scand J Gastroenterol, 30, pp.699~706 (1995)
  80. Wisniewski A, "Evolving treatment algorithms in Crohn’s disease", Curr Drug Targets, 19, pp.782~790 (2018)
  81. Lichtenstein GR, "Approach to corticosteroid-dependent and corticosteroid-refractory Crohn’s disease", Inflamm Bowel Dis, 7(Suppl 1), pp.S23~S29 (2001)
  82. Cucchiara S, "Polymorphisms of tumor necrosis factor-alpha but not MDR1 influence response to medical therapy in pediatric-onset inflammatory bowel disease", J Pediatr Gastroenterol Nutr, 44, pp.171~179 (2007)
  83. Beaugerie L, "Clinical, serological and genetic predictors of inflammatory bowel disease course", World J Gastroenterol, 18, pp.3806~3813 (2012)
  84. Ben-Horin S, "Optimizing anti-TNF treatments in inflammatory bowel disease", Autoimmun Rev, 13, pp.24~30 (2014)
  85. Siegel CA, "Predicting response to anti-TNF agents for the treatment of Crohn’s disease", Therap Adv Gastroenterol, 2, pp.245~251 (2009)
  86. Carbonnel F, "Crohn’s disease severity in familial and sporadic cases", Gut, 44, pp.91~95 (1999)
  87. Henriksen M, "Are there any differences in phenotype or disease course between familial and sporadic cases of inflammatory bowel disease? Results of a population-based follow-up study", Am J Gastroenterol, 102, pp.1955~1963 (2007)
  88. Sands BE, "Effects of vedolizumab induction therapy for patients with Crohn’s disease in whom tumor necrosis factor antagonist treatment failed", Gastroenterology, 147, pp.618~627 (2014)
  89. Alric H, "The effectiveness of either ustekinumab or vedolizumab in 239 patients with Crohn’s disease refractory to anti-tumour necrosis factor", Aliment Pharmacol Ther, 51, pp.948~957 (2020)
  90. Kennedy NA, "Predictors of anti-TNF treatment failure in anti-TNF-naive patients with active luminal Crohn’s disease : a prospective, multicentre, cohort study", Lancet Gastroenterol Hepatol, 4, pp.341~353 (2019)
  91. Dalal RS, "Predictors of ustekinumab failure in Crohn’s disease after dose intensification", Inflamm Bowel Dis, 27, pp.1294~1301 (2021)
  92. Hoffmann P, "Ustekinumab : "Realworld"outcomes and potential predictors of nonresponse in treatment-refractory Crohn’s disease", World J Gastroenterol, 25, pp.4481~4492 (2019)
  93. Bernstein CN, "Hospitalisations and surgery in Crohn’s disease", Gut, 61, pp.622~629 (2012)
  94. Jeuring SF, "Improvements in the long-term outcome of Crohn’s disease over the past two decades and the relation to changes in medical management : results from the population-based IBDSL cohort", Am J Gastroenterol, 112, pp.325~336 (2017)
  95. Sutherland LR, "Effect of cigarette smoking on recurrence of Crohn’s disease", Gastroenterology, 98(5 Pt 1), pp.1123~1128 (1990)
  96. Nguyen GC, "Outcomes of patients with Crohn’s disease improved from 1988 to 2008and were associated with increased specialist care", Gastroenterology, 141, pp.90~97 (2011)
  97. Alvarez-Lobos M, "Crohn’s disease patients carrying Nod2", CARD15 gene variants have an increased and early need for first surgery due to stricturing disease and higher rate of surgical recurrence, 2005, pp.242, 693~700
  98. Golovics PA, "Inflammatory bowel disease course in Crohn’s disease : is the natural history changing", World J Gastroenterol, 20, pp.3198~3207 (2014)

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