Patients With Stricturing or Penetrating Crohn’s Disease Phenotypes Report High Disease Burden and Treatment Needs

Yanni Fan, Ling Zhang, Negar Omidakhsh, Rhonda L. Bohn, Jennifer S. Thompson, Kimberly G. Brodovicz, Parakkal Deepak

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

Background: Crohn’s disease (CD) is a chronic autoimmune disease in which inflammation can progress to complications of stricturing and/or penetrating disease. Real-world data on burden of complicated CD phenotypes are limited. Methods: We analyzed cross-sectional data from the SPARC IBD (Study of a Prospective Adult Research Cohort with Inflammatory Bowel Disease) registry from 2016 to 2020. Four mutually exclusive phenotype cohorts were created: inflammatory CD (CD-I), complicated CD (stricturing CD, penetrating CD, and stricturing and penetrating CD [CD-SP]). Statistical analyses were performed using CD-I as the reference. Results: A total of 1557 patients were identified: CD-I (n = 674, 43.3%), stricturing CD (n = 457, 29.4%), penetrating CD (n = 166, 10.7%), and CD-SP (n = 260, 16.7%). Patients with complicated phenotypes reported significantly greater use of tumor necrosis factor inhibitors (84.2%-86.7% vs 66.0%; P < .001) and corticosteroids (75.3%-82.7% vs 68.0%; P < .001). Patients with CD-SP reported significantly more aphthous ulcer (15.4% vs 10.5%; P < .05), erythema nodosum (6.5% vs 3.6%; P < .05), inflammatory bowel disease-related arthropathy (25.8% vs 17.2%; P < .01), liquid stools (24.2% vs 9.3%; P < .001), nocturnal fecal incontinence (10.8% vs 2.5%; P < .001), and CD-related surgery (77.7% vs 12.2%; P < .001). Conclusions: Patients with complicated CD phenotypes reported higher rates of active CD-related luminal and extraintestinal manifestations, and underwent more surgeries, despite being more likely to have received biologics than those with CD-I. The potential for early recognition and management of CD-I to prevent progression to complicated phenotypes should be explored in longitudinal studies.

Original languageEnglish
Pages (from-to)914-922
Number of pages9
JournalInflammatory bowel diseases
Volume29
Issue number6
DOIs
StatePublished - Jun 1 2023

Keywords

  • Crohn’s disease complications
  • biologics
  • penetrating Crohn’s disease
  • stricturing Crohn’s disease

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