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KMID : 1188320160100040595
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Gut and Liver
2016 Volume.10 No. 4 p.595 ~ p.603
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Disease Phenotype, Activity and Clinical Course Prediction Based on C-Reactive Protein Levels at Diagnosis in Patients with Crohn’s Disease: Results from the CONNECT Study
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Kwon Jee-Hye
Im Jong-Pil
Ye Byong-Duk
Cheon Jae-Hee
Jang Hyun-Joo
Lee Kang-Moon
Kim You-Sun
Kim Sang-Wook
Kim Young-Ho
Song Geun-Am
Han Dong-Soo
Kim Won-Ho
Kim Joo-Sung
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Abstract
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Background/Aims:C-reactive protein (CRP) is an easily measured index of disease activity, but its ability to predict clinical course is controversial. We therefore designed a study to determine whether the CRP level at Crohn’s disease (CD) diagnosis is a valuable indicator of the disease phenotype, activity, and clinical course.
Methods:We retrospectively analyzed 705 CD patients from 32 institutions. The patients were classified into two groups according to CRP level. The patients’ demographic and clinical characteristics and their use of immunosuppressive or biological agents were recorded. Disease location and behavior, hospitalization, and surgery were analyzed.
Results:A high CRP was associated with younger age, steroid use, colonic or ileocolonic location, high CD activity index, and active inflammation at colonoscopy (p<0.001). As the disease progressed, patients with high CRP were more likely to exhibit strictures (p=0.027). There were significant differences in the use of 5-aminosalicylic acid, antibiotics, corticosteroids, azathioprine, and infliximab (p<0.001, p<0.001, p<0.001, p<0.001, and p=0.023, respectively). Hospitalization was also more frequent in patients with high CRP.
Conclusions:The CRP level at diagnosis is useful for evaluating the phenotype, activity, and clinical course of CD. Closer follow-up strategies, with early aggressive treatment, could be considered for patients with high CRP.
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KEYWORD
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Crohn disease, C-reactive protein, Clinical course
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