Population‐based cases control study of inflammatory bowel disease risk factors

Gearry, Richard B.; Richardson, Ann; Frampton, Christopher; Dodgshun, Andrew; Barclay, Murray L.

doi:10.1111/j.1440-1746.2009.06140.x

Cited by 201 publications

(181 citation statements)

References 53 publications

(112 reference statements)

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“…6,7,[17][18][19] The natural disease course for CD is highly variable among patients ranging from mild cases requiring dietary modification to severe cases requiring surgery. Therefore, clinicians need to be accurate in their diagnosis and prediction of disease progression when treating patients in order to personalise medical therapy and optimise outcome.…”

Section: Discussionmentioning

confidence: 99%

“…6 The selection of patients, their data collection, as well as DNA extraction and genotyping was previously performed as part of the Canterbury Inflammatory Bowel Disease (IBD) Project. 6,7 Briefly, all patients were diagnosed with CD and phenotyped using the Montreal Classification System (MCS). 6,7 Clinical data were gathered for 715 CD patients in the Canterbury IBD study.…”

Section: Patient Selection and Data Ascertainmentmentioning

confidence: 99%

“…Environmental data were collected using a selfadministered questionnaire. 6 The primary outcome variable was the need for any type of IBD-related surgery in CD patients. This outcome variable was generalised to include all types of IBD-related surgical resections as determined from patient records by the lead investigative clinicians (RG and MB) at the time of recruitment.…”

Section: Patient Selection and Data Ascertainmentmentioning

confidence: 99%

“…6,7 Briefly, all patients were diagnosed with CD and phenotyped using the Montreal Classification System (MCS). 6,7 Clinical data were gathered for 715 CD patients in the Canterbury IBD study. Genotype data were available for 503 patients.…”

Section: Patient Selection and Data Ascertainmentmentioning

confidence: 99%

“…2,3 A range of factors have been associated with an increased risk of complicated (stricturing and penetrating) CD behaviour including the specific NOD2 genotypes [4][5][6] having had perianal disease [8][9][10][11] and cigarette smoking. 1,6,8,[12][13][14] Complicated disease is strongly associated with a requirement for surgery 15 ; therefore, knowledge of such genetic, environmental and clinical predictors may guide clinicians in developing a personalised approach for individual patients. 2,3,16 The ability to predict those who will have a more indolent disease course is also important given the range of adverse drug reactions and the cost of anti-TNF drugs.…”

Section: Introductionmentioning

confidence: 99%

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An Envirogenomic Signature Is Associated with Risk of IBD-Related Surgery in a Population-Based Crohn’s Disease Cohort

Nasir

Griffiths

Nasir

et al. 2013

Journal of Gastrointestinal Surgery

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Background and Aims Crohn's disease (CD) is an inflammatory bowel disease (IBD) caused by a combination of genetic, clinical, and environmental factors. Identification of CD patients at high risk of requiring surgery may assist clinicians to decide on a top-down or step-up treatment approach. Methods We conducted a retrospective case-control analysis of a population-based cohort of 503 CD patients. A regressionbased data reduction approach was used to systematically analyse 63 genomic, clinical and environmental factors for association with IBD-related surgery as the primary outcome variable. Results A multi-factor model was identified that yielded the highest predictive accuracy for need for surgery. The factors included in the model were the NOD2 genotype (OR=1.607, P=2.3×10 −5 ), having ever had perianal disease (OR=2.847, P=4×10 −6 ), being post-diagnosis smokers (OR=6.312, P=7.4×10 −3 ), being an ex-smoker at diagnosis (OR=2.405, P=1.1×10 −3 ) and age (OR=1.012, P=4.4×10 −3 ). Diagnostic testing for this multi-factor model produced an area under the curve of 0.681 (P=1×10 −4 ) and an odds ratio of 3.169, (95 % CI P=1×10 −4 ) which was higher than any factor considered independently.Conclusions The results of this study require validation in other populations but represent a step forward in the development of more accurate prognostic tests for clinicians to prescribe the most optimal treatment approach for complicated CD patients.

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Section: Discussionmentioning

confidence: 99%

Section: Patient Selection and Data Ascertainmentmentioning

confidence: 99%

Section: Patient Selection and Data Ascertainmentmentioning

confidence: 99%

Section: Patient Selection and Data Ascertainmentmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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An Envirogenomic Signature Is Associated with Risk of IBD-Related Surgery in a Population-Based Crohn’s Disease Cohort

Nasir

Griffiths

Nasir

et al. 2013

Journal of Gastrointestinal Surgery

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Crohn's Disease: Clinical Manifestations and Management

Melmed

Targan

2015

Yamada' S Textbook of Gastroenterology

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Baseline radiographic damage, elevated acute‐phase reactant levels, and cigarette smoking status predict spinal radiographic progression in early axial spondylarthritis

Poddubnyy

Haibel

Listing

et al. 2012

Arthritis & Rheumatism

414

254

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Objective. To assess prospectively the rates and to explore predictors of spinal radiographic progression over 2 years in a cohort of patients with early axial spondylarthritis (SpA).Methods. Two hundred ten patients with axial SpA from the German Spondyloarthritis Inception Cohort were selected for this analysis based on the availability of radiographs at baseline and after 2 years of followup. Spinal radiographs were scored by 2 trained readers in a blinded, randomly selected order according to the modified Stoke Ankylosing Spondylitis Spine Score (mSASSS). Spinal radiographic progression was defined as worsening of the mean mSASSS by >2 units over 2 years.Results. Among the patients with axial SpA, 14.3% showed spinal radiographic progression after 2 years (20% of those with AS and 7.4% of those with nonradiographic axial SpA). The following parameters were independently associated with spinal radiographic progression: presence of syndesmophytes at baseline (odds ratio [OR] 6.29, P < 0.001), elevated levels of markers of systemic inflammation (for the erythrocyte sedimentation rate, OR 4.04, P ‫؍‬ 0.001; for C-reactive protein level time-averaged over 2 years, OR 3.81, P ‫؍‬ 0.001), and cigarette smoking (OR 2.75, P ‫؍‬ 0.012). These associations were confirmed by multivariate logistic regression analysis. No clear association with spinal radiographic progression was observed for HLA-B27 status, sex, age, disease duration, Bath Ankylosing Spondylitis Disease Activity Index, Bath Ankylosing Spondylitis Functional Index, presence of peripheral arthritis, enthesitis, psoriasis, treatment with nonsteroidal antiinflammatory drugs, or treatment with disease-modifying antirheumatic drugs at baseline.Conclusion. The presence of radiographic damage at baseline (syndesmophytes), elevated levels of acutephase reactants, and cigarette smoking were all independently associated with spinal radiographic progression in patients with early axial SpA.The term axial spondylarthritis (SpA) refers to patients with radiographic sacroiliitis fulfilling the modified New York criteria for ankylosing spondylitis (AS) (1) and patients with nonradiographic axial SpA (i.e., patients without definite radiographic changes in the sacroiliac joints) (2).

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Population‐based cases control study of inflammatory bowel disease risk factors

Abstract: The importance of childhood factors in the development of IBD is confirmed. The duration-response protective association between breast-feeding and subsequent development of IBD requires further evaluation, as does the protective effect associated with a childhood vegetable garden.

Cited by 201 publications

References 53 publications

An Envirogenomic Signature Is Associated with Risk of IBD-Related Surgery in a Population-Based Crohn’s Disease Cohort

An Envirogenomic Signature Is Associated with Risk of IBD-Related Surgery in a Population-Based Crohn’s Disease Cohort

Crohn's Disease: Clinical Manifestations and Management

Baseline radiographic damage, elevated acute‐phase reactant levels, and cigarette smoking status predict spinal radiographic progression in early axial spondylarthritis

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