Long-term Prognosis of Crohnʼs Disease and Its Temporal Change Between 1981 and 2012

Park, Sang Hyoung; Yang, Suk‐Kyun; Park, Soo-Kyung; Kim, Jong Wook; Yang, Dan; Jung, Kee Wook; Kim, Kyung‐Jo; Ye, Byong Duk; Byeon, Jeong‐Sik; Myung, Seung‐Jae; Yoon, Yong Sik; Yu, Chang Sik; Kim, Jin-Ho

doi:10.1097/01.mib.0000441203.56196.46

Cited by 93 publications

(110 citation statements)

References 28 publications

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“…Of note, hospital-based cohort studies may have a selection bias which limits the generalization of results to the population as a whole. Nevertheless, the demographic and clinical characteristics of our hospitalbased studies [43,44] are quite similar to those of a previous population-based cohort study [4] for IBD in Korea.…”

Section: Natural Historysupporting

confidence: 70%

“…Therefore, we performed hospital-based cohort studies to evaluate the long-term clinical course in 2,802 Korean patients with UC [43] and in 2,043 Korean patients with CD [44] . In these studies, the patients were divided into 3 consecutive cohorts according to the date of diagnosis in order to evaluate changes in treatment paradigms and the prognoses of UC and CD during the study period (1977-2013 for UC and 1981-2012 for CD).…”

Section: Natural Historymentioning

confidence: 99%

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How Does the Epidemiology of Inflammatory Bowel Disease Differ between East and West? A Korean Perspective

Yang¹

2017

Inflamm Intest Dis

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Background: Though low compared with those in Western countries, the incidence and prevalence of inflammatory bowel disease (IBD) are rapidly increasing in Asia. If we could understand the differences in IBD epidemiology between Asian and Western countries, we might gain insights into the etiopathogenesis of IBD as well as guidance for personalized therapy. Summary: In Asia, unlike in the West, Crohn's disease (CD) predominantly occurs in men and involves a high prevalence of perianal fistulas. Moreover, in Korean CD patients, ileocolonic involvement is predominant, whereas isolated colonic involvement is very uncommon. In both ulcerative colitis (UC) and CD, extraintestinal manifestations, such as primary sclerosing cholangitis, as well as a positive family history of IBD are less frequent in Asian patients. However, as the prevalence of IBD rises in Korea, so does the frequency of a positive family history. While the colectomy rate among Korean UC patients is lower, the intestinal resection rate in CD patients is similar in Korea and in the West. Infectious problems that can adversely influence IBD management are usually more common in Asia. Key Messages: IBD in Asians differs from that in Westerners in many aspects, including demographic and clinical characteristics, prognosis, and associated problems.

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Section: Natural Historysupporting

confidence: 70%

Section: Natural Historymentioning

confidence: 99%

How Does the Epidemiology of Inflammatory Bowel Disease Differ between East and West? A Korean Perspective

Yang¹

2017

Inflamm Intest Dis

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“…[21][22][23][24] Although it is not clear whether differences in disease prevalence by sex are genetic and due to differences in effects conferred by common variants, the X chromosome-wide association study could help in explaining the male predominance among Korean patients with CD. When we performed sex-stratified analyses to test whether differences in the effect size of the top SNP on the X chromosome exist between males and females, we failed to identify any significant sex-specific differences in effect size [ Table 3].…”

Section: Discussionmentioning

confidence: 99%

“…Recent studies from Korea, China, and Japan have consistently reported a male predominance of Crohn's disease [CD] among Asian patients with CD, [21][22][23][24] whereas studies from Western countries report an equal ratio or slight shift toward female predominance. 25 However, Asian GWASs of CD have seldom included the X chromosome 26,27 or did not identify any loci on the X chromosome at a genome-wide significance level.…”

Section: Introductionmentioning

confidence: 99%

X Chromosome-wide Association Study Identifies a Susceptibility Locus for Inflammatory Bowel Disease in Koreans

Lee

Yang

et al. 2017

Journal of Crohn's and Colitis

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Background and Aims: Genome-wide association studies of inflammatory bowel disease identified > 200 susceptibility loci only in autosomes. This study aimed to identify inflammatory bowel disease susceptibility loci on the X chromosome. Methods: We performed an X chromosome-wide association study in Korean patients with inflammatory bowel disease. We analysed X chromosome data from our recent genome-wide association studies, including 1505 cases [922 Crohn's disease and 583 ulcerative colitis] and 4041 controls during the discovery phase, followed by replication in additional 1989 cases [993 Crohn's disease, 996 ulcerative colitis] and 3491 controls. Sex-related differential effects of single nucleotide polymorphisms on disease were also evaluated. Results: We confirmed a significant association of a previously reported inflammatory bowel disease susceptibility locus at chromosome Xq26.3 [CD40LG-ARHGEF6; odds ratio, 1.22; 95% confidence interval, 1.16-1.28; combined p = 3.79 × 10]. This locus accounted for 0.18% and 0.12% of genetic variance in Crohn's disease and ulcerative colitis, respectively, and increased the total autosomal chromosome genetic variance from 6.65% to 6.83% and from 5.47% to 5.59% for Crohn's disease and ulcerative colitis risk, respectively, in the Korean population. Sex-stratified analyses did not reveal sex-related differences in effect sizes. Conclusions:We confirmed the association of rs2427870 at the CD40LG-ARHGEF6 locus with an inflammatory bowel disease through an X chromosome-wide association study in a Korean Downloaded from https://academic.oup.com/ecco-jcc/article-abstract/11/7/820/3041097 by guest on 07 June 2019 population. Our data suggest that the CD40LG-ARHGEF6 locus on the X chromosome might play a role in inflammatory bowel disease pathogenesis in the Korean population.

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“…In a previous large hospital-based study from Korea [7] that analyzed 2,043 patients with CD, 94.1% of participants were diagnosed before 40 years of age, 43.2% had experienced perianal fistula at diagnosis and 91.6% had had ileal or ileocolonic disease. A question that arises from this is whether Korean patients with CD have a poorer prognosis than Caucasians.…”

Section: Clinical and Endoscopic Predictorsmentioning

confidence: 99%

Personalizing IBD Therapy: The Asian Perspective

Yang

2016

Dig Dis

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Background: All patients with inflammatory bowel disease (IBD) share common therapeutic goals, such as complete mucosal healing and improved long-term outcomes (e.g., reduction in hospitalization, surgery and mortality). However, because IBD patients have diverse features in terms of severity, phenotypes, clinical courses and responses to therapy, therapeutic options for achieving these goals differ among patients, from no therapy to early introduction of combination therapy with anti-TNF and immunosuppressive agents. Key Messages: By personalizing IBD therapy, we may be able to maximize management efficacy, minimize the risk of adverse events and ultimately decrease costs. The initial steps of personalized therapy involve the selection of the right patients by predicting the clinical course of IBD and the subsequent selection of the right therapy by predicting the response to therapy. The next step of personalized therapy involves the adjustment of therapy through therapeutic response evaluation and therapeutic drug monitoring. Notably, current recommendations on personalized IBD therapy are mainly based on results derived from Western populations. However, Asian patients with IBD are different from Western patients in many respects, including clinical characteristics, therapeutic response and prognosis, probably due to differences in environmental and genetic backgrounds. In addition, the healthcare systems and sociocultural backgrounds of Asian countries are not the same as those of Western countries. Therefore, personalized IBD therapy for Asians may differ from that for Westerners in some aspects. Conclusions: This review discusses the current progress of personalized IBD therapy and its application from the Asian perspective.

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Long-term Prognosis of Crohnʼs Disease and Its Temporal Change Between 1981 and 2012

Abstract: Korean patients with CD may have a similar clinical course to Westerners, as indicated by the intestinal resection rate. The surgery rate has decreased over time, and early use of azathioprine/6-mercaptopurine was related to its decrease.

Cited by 93 publications

References 28 publications

How Does the Epidemiology of Inflammatory Bowel Disease Differ between East and West? A Korean Perspective

How Does the Epidemiology of Inflammatory Bowel Disease Differ between East and West? A Korean Perspective

X Chromosome-wide Association Study Identifies a Susceptibility Locus for Inflammatory Bowel Disease in Koreans

Personalizing IBD Therapy: The Asian Perspective

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