Idiopathic inflammatory bowel disease – prediction and treatment
Authors:
Karel Lukáš
Authors‘ workplace:
Univerzita Karlova v Praze, 1. lékařská fakulta, IV. interní klinika VFN
Published in:
Čas. Lék. čes. 2011; 150: 315-320
Category:
Review Article
Overview
Currently the strongest predictors of disease course in Crohn’s disease and ulcerative colitis are the age at diagnosis, disease location and smoking habit. Younger age at the onset is associated with more aggressive disease both in Crohn’s disease and ulcerative colitis. Disease location in Crohn’s disease is associated with different types of complications: surgery and recurrence in upper gastrointestinal and proximal small bowel disease; and surgery in distal small bowel disease and peri-anal lesions in rectal disease. In ulcerative colitis, extensive colitis is clearly associated with more severe disease. Active smoking globally increases disease severity in Crohn’s disease but decreases it in ulcerative colitis. In Crohn’s disease, proximal small bowel and upper gastrointestinal tract location is associated with risk of recurrence and surgery; small bowel disease with risk of surgery; and colonic disease, and particularly rectal disease, is associated with increased risk of peri-anal lesions. In ulcerative colitis, extensive colitis is associated with increased risk of colorectal cancer and colectomy. Individual treatment of patients with inflammatory bowel disease depends on disease location and severity. There is increasing evidence that early intervention with immunosuppressives or biologic agents aimed at tumor necrosis factor-α usually has rapid and prolonged benefits, including steroid sparing, reductions in hospitalizations and, reductions in the need for surgery.
Key words:
inflammatory bowel disease, Crohn’s disease, ulcerative colitis, predict, therapy.
Sources
1. Loftus EV. Jr. Clinical epidemiology of inflammatory bowel disease: incidence, prevalence, and environmental influences. Gastroenterology 2004; 126: 1504–1517.
2. Engel MA, Neurath MF. New pathophysiological insights and modern treatment of IBD. J. Gastroenterol 2010; 45: 571–583.
3. Satsangi J, Silverberg M S, Vermeire S, Colombel J-F. The Montreal classification of inflammatory bowel disease: controversies, consensus, and implications. Gut 006; 55(6): 749–753.
4. Gasche C, cholmerich J, rynskov J, et al. A simple classification of Crohn‘s disease: report of the Working Party for the World Congresses of Gastroenterology, Vienna 1998. Inflamm Bowel Dis 000; 6(1): 8–15.
5. Louis E, ollard A, ger AF, egroote E, boul Nasr El Yafi FA, elaiche J. Behaviour of Crohn‘s disease according to the Vienna classification: changing pattern over the course of the disease. Gut 001; 49(6): 777–782.
6. Cosnes J, Cattan S, Blain A, et al. Long-term evolution of disease behavior of Crohn‘s disease. Inflammatory Bowel Diseases 2002; 8(4): 244–250.
7. Michener WM, Whelan G, Greenstreet RL, Farmer RG. Comparison of the clinical features of Crohn‘s disease and ulcerative colitis with onset in childhood or adolescence. leve Clin Q 1982; 49: 13–16.
8. Hoie O, Wolters FL, Riis L, et al. Low colectomy rates in ulcerative colitis in an unselected European cohort followed for 10 years. astroenterology 007; 132: 507–515.
9. Louis E, Michel V, Hugot JP, Reenaers C, et al. Early development of stricturing or penetrating pattern in Crohn‘s disease is influenced by disease location, number of flares, and smoking but not by NOD2/CARD15 genotype. ut 2003; 52: 552–557.
10. Lakatos PL, Czegledi Z, Szamosi T, et al. 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. orld J Gastroenterol 009; 15: 3504–3510.
11. Henckaerts L, Van Steen K, Verstreken I, et al. Genetic risk profiling and prediction of disease course in Crohn‘s disease patients. lin Gastroenterol Hepatol 009; 7: 972–980.
12. Romberg-Camps MJ, Dagnelie PC, Kester AD, et al. Influence of phenotype at diagnosis and of other potential prognostic factors on the course of inflammatory bowel disease. m J Gastroenterol 009; 104: 371–383
13. Wolters FL, Russel MG, Sijbrandij J, et al. Phenotype at diagnosis predicts recurrence rates in Crohn‘s disease. ut 2006; 55: 1124–1130.
14. Chow DK, Sung JJ, Wu JC, Tsoi KK, Leong RW, Chan FK. Upper gastrointestinal tract phenotype of Crohn‘s disease is associated with early surgery and further hospitalization. Inflamm Bowel Dis 2009; 15: 551–557.
15. Hellers G. Occurrence and outcome after primary treatment of anal fistulae in Crohn‘s disease. Gut 980; 21: 525–527.
16. Louis E, ollard A, ger AF, egroote E, boul Nasr El Yafi FA, elaiche J. Behaviour of Crohn‘s disease according to the Vienna classification: changing pattern over the course of the disease. Gut 001; 49(6): 777–782.
17. Bernell O, et al. Risk factors for surgery and postoperative recurrence in Crohn‘s disease. Ann Surg January 2000; 231: 38–45.
18. Loly C, Belaiche J, Louis E. Predictors of severe Crohn‘s disease. cand J Gastroenterol 2008; 43: 948–954.
19. Beaugerie L, eksik P, ion-Larmurier I, endre JP, osnes J. Predictors of Crohn‘s disease. Gastroenterology 2006; 130(3): 650–656.
20. Loly C, Belaiche J, Louis E. Predictors of severe Crohn‘s disease. cand J Gastroenterol 2008; 43: 948–954.
21. Tibble JA, igthorsson G, ridger S, agerhol MK, jarnason I. Surrogate markers of intestinal inflammation are predictive of relapse in patients with inflammatory bowel disease. Gastroenterology 000; 119(1): 15–22.
22. Tibble J, Teahon K, Thjodleifsson B, et al. A simple method for assessing intestinal inflammation in Crohn‘s disease. ut 000; 47: 506–513.
23. Gisbert JP, ermejo F, érez-Calle JL, et al. Fecal calprotectin and lactoferrin for the prediction of inflammatory bowel disease relapse. Inflamm Bowel Dis 009; 15(8): 1190–1198.
24. Zisman TL. Novel diagnostic and prognostic modalities in inflammatory bowel disease. Med clin north Am January 2010; 94(1): 155–157.
25. von Roon AC, Karamountzos L, Purkayastha S, t al. Diagnostic precision of fecal calprotectin for inflammatory bowel disease and colorectal malignancy. m J Gastroenterol 2007; 102: 803–813.
26. Wagner M, Peterson C GB, Ridefelt P, Sangfelt P, Carlson M. Fecal markers of inflammation used as surrogate markers for treatment outcome in relapsing inflammatory bowel disease. World J astroenterol 2008 September 28; 14(36): 5584–5589.
27. Costa F, Mumolo MG, Ceccarelli L, et al. Calprotectin is a tronger predictive marker of relapse in ulcerative colitis than in Crohn‘s disease. ut 005; 54: 364–368.
28. Gisbert JP, ermejo F, érez-Calle JL, et al. Fecal calprotectin and lactoferrin for the prediction of inflammatory bowel disease relapse. Inflamm Bowel Dis 009; 15(8): 1190–1198.
29. D‘Inca R, Dal Pont E, Di Leo V, t al. Calprotectin and lactoferrin in the assessment of intestinal inflammation and organic disease. nt J Colorectal Dis 007; 22: 429–437.
30. Allez M, Lemann M. Role of endoscopy in predicting the disease course in inflammatory bowel disease. World J Gastroenterol 010; 16(21): 2626–2632.
31. Hass DJ, Brensinger CM, Lewis JD, Lichtenstein GR. The impact of increased body mass index on the clinical course of Crohn‘s disease. lin Gastroenterol Hepatol 006; 4(4): 482–488.
32. Ida A, Koyama K. Ulcerative colitis and pregnancy. Nippon Rinsho 1999; 57(11): 2603–2607.
33. Alstead EM. Inflammatory bowel disease in pregnancy. Postgrad Med J 2002; 78 (923): 572.
34. Mayberry JF, Weterman IT. European survey of fertility and pregnancy in women with Crohn‘s disease: a case control study by European collaborative group. Gut 1986; 27 (7): 821–825.
35. Zimmermann EM. Approach to Gastrointestinal Disease in the Female Patiens. In: Textbook of Gastroenterology. Yamada T. (ed.) Lippincott: Williams & Wilkins 1999;1059–1080.
36. Rajapakse RO, Korelitz BI, Zlatanic J, Baiocco PJ, Gleim GW. Outcome of pregnancies when fathers are treated with 6‑mercaptopurine for inflammatory bowel disease. Am J Gastroenterol 2000; 95(3): 684–688.
37. Korelitz BI. Inflammatory bowel disease and pregnancy. Gastroenterol Clin N Amer 1998; 27(1): 213–224.
38. Heetun ZS, Byrnes C, Neary P, O‘Morain C. Review article: Reproduction in the patient with inflammatory bowel disease. Aliment Pharmacol Ther 2007; 26(4): 513–518.
39. Hinkes E, Plotkin D. Reversible drug-induced sterility in a patient with acute leukemia. JAMA 1973; 223(13): 1490–1491.
40. Lukáš K, ařízek A, otlas J, ovotný A. Idiopatické střevní záněty a těhotenství. Čas Lék čes 2010; 149: 163–172.
41. Suominen JS, Wang Y, Kaipia A, Toppari J. Tumor necrosis factor-alpha (TNF-alpha) promotes cell survival during spermatogenesis, and this effect can be blocked by infliximab, a TNF-alpha antagonist. Eur J Endocrinol 2004; 151(5): 629–640.
42. Mogadam M, Korelitz BI, Ahmed SW, Dobbins WO 3rd, Baiocco PJ. The course of inflammatory bowel disease during pregnancy and postpartum. Am J Gastroenterol 1981; 75(4): 265–269.
43. Miller JP. Inflammatory bowel disease in pregnancy: a review. J R Soc Med 1986; 79(4): 221–225.
44. Reddy D, Murphy SJ, Kane SV, Present DH, Kornbluth AA. Relapses of inflammatory bowel disease during pregnancy: in-hospital management and birth outcomes. Am J Gastroenterol 2008; 103(5): 1203–1209.
45. Sonnenberg A. Date of birth in the occurrence of inflammatory bowel disease. Inflamm Bowel Dis 2009; 15(2): 206–211.
46. Cosnes J, Beaugerie L, Carbonnel F, Gendre JP. Smoking cessation and the course of Crohn‘s disease: an intervention study. astroenterology 001; 120: 1093–1099.
47. Brant SR, Picco MF, Achkar JP, et al. Defining complex contributions of NOD2/CARD15 gene mutations, age at onset, and tobacco use on Crohn‘s disease phenotypes. nflamm Bowel Dis 003; 9: 281–289.
48. Seksik P, Nion-Larmurier I, Sokol H, Beaugerie L, Cosnes J. Effects of light smoking consumption on the clinical course of Crohn‘s disease. nflamm Bowel Dis 009; 15: 734–741.
49. Gower-Rousseau C, Dauchet L, Vernier-Massouille G, et al. The natural history of pediatric ulcerative colitis: a population-based cohort study. m J Gastroenterol 009; 104: 2080–2088
50. Beaugerie L, Massot N, Carbonnel F, Cattan S, Gendre JP, Cosnes J. Impact of cessation of smoking on the course of ulcerative colitis. m J Gastroenterol 001; 96: 2113–2116.
51. Boyko EJ, Perera DR, Koepsell TD, Keane EM, Inui TS. Effects of cigarette smoking on the clinical course of ulcerative colitis. cand J Gastroenterol 988; 23: 1147–1152.
52. Szamosi T, Banai J, Lakatos L, et al. Early azathioprine/biological therapy is associated with decreased risk for first surgery and delays time to surgery but not reoperation in both smokers and nonsmokers with Crohn‘s disease, while smoking decreases the risk of colectomy in ulcerative colitis. ur J Gastroenterol Hepatol 2010; 22(7): 872–879.
53. Langholz E, Munkholm P, Davidsen M, Binder V. Colorectal cancer risk and mortality in patients with ulcerative colitis.Gastroenterology 992; 103: 1444–1451.
54. Devroede GJ, Tailor WF, Bauer WG, Jackman RJ, Stickler GB. Cancer Risk and Life Expectancy of Children with Ulcerative Colitis. N Engl J Med 1971; 285: 17–21.
55. Ekbom A, elmick CG, ack M, olmberg L, dami HO. Survival and causes of death in patients with inflammatory bowel disease: a population-based study. Gastroenterology 992; 103(3): 954–960.
56. Etchevers MJ, Aceituno M, García-Bosch O, Ordás I, Sans M, Ricart E, Panés J. Risk factors and characteristics of extent progression in ulcerative colitis. nflamm Bowel Dis 009; 15: 1320–1325.
57. Oldenburg B, ommes D. Biological therapies in inflammatory bowel disease: top-down or bottom-up? Curr Opin Gastroenterol 007; 23: 395–399.
58. Orchard T. NICE guidance for anti tumour necrosis factor therapy in Crohn’s disease: Chat does it mean for the inflammatory bowel disease. Frontline Gastroenterology 2010; 1(3): 144–146.
59. Krygier DS, o HH, ressler B. How to manage difficult Crohn‘s disease: optimum delivery of anti-TNFs. Expert Rev Gastroenterol Hepatol 2009; 3(4): 407–415.
60. Triantafillidis JK, Mantzaris G, Karagiannis J, et al. Similar response to adalimumab in patients with active Crohn‘s disease either naive to biologic agents or with prior loss of response or intolerance to infliximab. Rev Med Chir Soc Med Nat Iasi 2010; 114(1): 85–90.
61. Szamosi T, Banai J, Lakatos L, et al. Early azathioprine/biological therapy is associated with decreased risk for first surgery and delays time to surgery but not reoperation in both smokers and nonsmokers with Crohn‘s disease, while smoking decreases the risk of colectomy in ulcerative colitis. European Journal of Gastroenterology & Hepatology 2010; 22(7): 872–879.
62. Hanauer SB. Positioning biologic agents in the treatment of Crohn‘s disease. Inflamm Bowel Dis 2009; 15: 1570–1582.
63. Colombel JF, Sandborn WJ, Reinisch W, et al. Infliximab, Azathioprine, or Combination Therapy for Crohn’s Disease. N Engl J Med 2010; 362: 1383–1395.
64. D’Haens G, aert , an Assche G, et al. Early combined immunosuppression or conventional management in patients with newly diagnosed Crohn‘s disease: an open randomised trial. Lancet 2008; 371(9613): 660–667.
65. Van Assche G, Vermeire S, Rutgeerts P. Safety issues with biological therapies for inflammatory bowel disease. Curr Opin Gastroenterol 2006; 22: 370–376.
66. Van Assche G Vermeire S, Rutgeerts P. Immunosuppression in inflammatory bowel disease: traditional, biological or both? Current Opinion in Gastroenterology 009; 25(4): 323–328.
67. Oussalah A, Chevaux JB, Fay R, Sandborn WJ, Bigard MA, Peyrin-Biroulet L. Predictors of infliximab failure after azathioprine withdrawal in Crohn‘s disease treated with combination therapy. Am J Gastroenterol 2010; 105(5): 1142–1149.
68. Shivananda S, Hordijk ML, Pena AS, Mayberry JF. Crohn‘s disease: risk of recurrence and reoperation in a defined population. Gut 1989; 30(7): 990–995.
69. Hellers G. Crohn‘s disease in Stockholm county 1955–1974. A study of epidemiology, results of surgical treatment and long-term prognosis. Acta Chir Scand Suppl 1979; 490: 1–84.
70. Bernell O, Lapidus A, Hellers G. Risk factors for surgery and recurrence in 907 patients with primary ileocaecal Crohn‘s disease. Br J Surg 2000; 87(12): 1697–1701.
71. Munkholm P, Langholz E, Davidsen M, Binder V. Disease activity courses in a regional cohort of Crohn‘s disease patients. Scand J Gastroenterol 1995; 30(7): 699–706.
72. Moum B, Ekbom A, Vatn MH, et al. Inflammatory bowel disease: re-evaluation of the diagnosis in a prospective population based study in south eastern Norway. Gut 1997; 40(3): 328–332.
73. Moum B, Ekbom A, Vatn MH, et al. Clinical course during the 1st year after diagnosis in ulcerative colitis and Crohn‘s disease. Results of a large, prospective population-based study in southeastern Norway, 1990–1993. Scand J Gastroenterol 1997; 32(10): 1005–1012.
74. Witte J, Shivananda S, Lennard-Jones JE, et al. Disease outcome in inflammatory bowel disease: mortality, morbidity and therapeutic management of a 796-person inception cohort in the European Collaborative Study on Inflammatory Bowel Disease (EC-IBD). Scand J Gastroenterol 2000; 35(12): 1272–1277.
75. Rutgeerts P, Geboes K, Vantrappen G, et al. Natural history of recurrent Crohn‘s disease at the ileocolonic anastomosis after curative surgery. Gut 1984; 25: 665–672.
76. Borley NR, Mortensen NJ, Jewell DP. Preventing post-operative recurrence of Crohn‘s disease. Br J Surg 1997; 84: 1493–1502.
77. Cottone M, Orlando A, Viscido A, Calabrese E, Cammą C, Casą A. Review article: prevention of postsurgical relapse and recurrence in Crohn‘s disease. Aliment Pharmacol Ther 2003; 17(Suppl 2): 38–42.
78. Hulten L. Surgical management and strategy in classical. Crohn‘s disease. Int Surg 1992; 77: 2–8.
79. Hulten LA. Long-term follow-up in Crohn‘s disease. World J Surg 1988; 12: 180–185.
80. Hulten L. Surgical treatment of Crohn‘s disease of the small bowel or ileocecum. World J Surg 1988; 12: 185–188.
81. Aratari A, Papi C, Leandro G, Viscido A, Capurso L, Caprilli R. Early versus late surgery for ileo-caecal Crohn‘s disease. Aliment Pharmacol Ther 2007; 26(10): 1303–1312.
82. Zisman TL, Rubin DT. Novel Diagnostic and Prognostic Modalities in Inflammatory Bowel Disease. In: Challenges in Inflammatory Bowel Disease. Regueiro M, Barrie III AM (eds.) Med Clin N Amer 2009; 94(1): 155–178.
83. Peyrin-Biroulet L, Loftus EV Jr, Colombel JF, Sandborn WJ. Early Crohn disease: a proposed definition for use in diseease-modification trials. Gut 2010; 59 (2): 141–147.
84. Peyrin-Biroulet, L. Crohn’s disease: early may already be too late. Gastroenterology 2008; 135: 1420–1422.
Labels
Addictology Allergology and clinical immunology Angiology Audiology Clinical biochemistry Dermatology & STDs Paediatric gastroenterology Paediatric surgery Paediatric cardiology Paediatric neurology Paediatric ENT Paediatric psychiatry Paediatric rheumatology Diabetology Pharmacy Vascular surgery Pain managementArticle was published in
Journal of Czech Physicians
Most read in this issue
- Variability of the deep femoral venous system
- Idiopathic inflammatory bowel disease – prediction and treatment
- Alcohol, tobacco and other addictive substances and reproductive health
- KRAS mutation testing in therapeutic algorithm for treatment of metastatic colorectal carcinoma