Introduction
CD is a chronic progressive disease associated with bowel damage and disability and with a globally increasing prevalence. Contemporary reports on the clinical presentation, disease outcomes, and treatment choices in newly diagnosed patients across Europe are important to inform physicians.
Aims & Methods
To describe the clinical characteristics in a contemporary European cohort of recently diagnosed CD patients. The Crohn´s Disease Cohort (CROCO) is an ongoing multicentre, European, prospective cohort study of recently diagnosed CD patients (within 12 months following diagnosis) intended to characterize bowel damage progression and disability. Herin, we report on the characteristics of CD-patients at inclusion in the study.
Results
Between Aug/21-April/24, 316 patients (58% male, 47% smoker or ex-smokers) with a median age at diagnosis of 34.4 (IQR 24.8; 49.6), were recruited from 17 centres. The median delay between symptoms onset and diagnosis was 6.5 months (IQR 2; 17.5); median disease duration at the time of inclusion was 3.9 months (IQR 1.6; 7.6); Ileal involvement (L1/L3) was reported in 86%. Overall, 15% had perianal disease and 28% had extra-intestinal manifestations, the most frequent being arthritis/arthralgia. One-third (32%) had evidence of either stricturing (B2) (17%) or penetrating (B3) (15%) phenotype; 7% had an intestinal-related surgery, and 2% perianal surgery. Fifty-nine (21%%) patients had at least one CD-related hospitalization. Median faecal calprotectin was was 236µg/g (IQR 75; 731) and median C-reactive protein was 4mg/L (IQR 1.2; 11). Regarding the therapies receiveid from diagnosis to inclusion, 54% of the patients had received systemic steroids, 18% 5ASA, 10% IM monotherapy, and 43% started biological therapy (126 anti-TNF, 6 anti-IL 12/23 and 3 anti-integrin).
Conclusion
In this prospective cohort of newly diagnosed CD-patients, more than one-third of the patients presented with a complicated phenotype despite a short delay between onset of symptoms and diagnosis. Steroids remain frequently used, however early and effective therapy was started in approximately in 40% of patients, highlighting the changing paradigm in CD treatment.
Disclosure
JB: Reports grants and personal fees from AbbVie, grants and personal fees from Janssen-Cilag, personal fees from Celgene, grants and personal fees from MSD, personal fees from Pfizer, grants and personal fees from Takeda, grants and personal fees from Tillots Pharma, personal fees from Samsung Bioepis, grants and personal fees from Bristol Myers Squibb, grants from Novo Nordisk, personal fees from Pharmacosmos, personal fees from Ferring, personal fees from Galapagos, outside the submitted work. NA: received speaker fees from Ferring and Janssen. PE: educational grants Jannsen; SV: Speaker fees from Abbvie, Ferring, Janssen Takeda. IR-L: has received financial support for travelling and educational activities from or has served as an advisory board member for Abbvie, Adacyte, Celltrion, Chiesi, Danone, Dr. Falk Pharma, Ferring, Faes Farma Janssen, Galapagos, MSD, Otsuka Pharmaceutical, Pfizer, Roche, Takeda, and Tillotts Pharma. IO: has served as speaker and/or consultant and has received educational funding from MSD, Abbvie, Pfizer, Takeda, Janssen, Faes Farma and Chiesi, and has received research funding from Abbvie and Faes Farma. DD: Lecture fee/consultancy from: Takeda, Pfizer, Janssen, Ferring, AbbVie, Eli-Lilly. SS: received consulting fees and advisory board fees from Takeda, AbbVie, Merck, Ferring, Pharmacocosmos, Warner Chilcott, Janssen, Falk Pharma, Biohit, TriGenix, Celgene, and Tillots Pharma; speaker honoraria from AbbVie, Takeda, Celltrion, Pfizer, Biogen, AbbVie, Janssen, Merck, Warner Chilcott, and Falk Pharma. VH: Has served as consultant, has served as speaker, has received travel support or research funding from MSD, AbbVie, Ferring, Dr. Falk Pharma, Tillotts Pharma, Pfizer, Takeda, Janssen, KernPharma Biologics, Adacyte, Sandoz, Biogen, Fresenius-Kabi, FAES Farma and Galapagos. MN: received board membership, consultancy, or lecture fees from Abbvie, Amgen, Biogen, Celltrion, Ferring, Fresenius-Kabi, Galapagos, Janssen, Lilly, Mayoli-Spindler, MSD, Nordic Pharma, Pfizer, Takeda, Viatris. MF: Lecture and consulting fees from Abbvie, Pfizer, Tillots, Takeda, Gilead, Arena, Sandoz, Celltrion, Galapagos, Celgene, Boehringer, Biogen, Viatris, Amgen, Fresenius, Celltrion, CTMA, Ferring and Janssen. MA: Speaker and consulting fees from Abbvie, Pfizer, Ferring and Janssen. BB: Speaker and consulting fees from Janssen, Takeda, Sofar, Alfasigma, Doxapharma. BB: Speaker and consulting fees from Janssen, Takeda, Sofar, Alfasigma, Doxapharma. RCU: has received consulting and/or advisory board fees from AbbVie, Bristol Myers Squibb, Celltrion, Janssen, Lilly, Pfizer, Roivant, Takeda. JC: receiving research grants from AbbVie, Janssen Pharmaceuticals and Takeda; receiving payment for lectures from AbbVie, Amgen, Anaptysbio, Allergan, Inc. Ferring Pharmaceuticals, Shire, and Takeda; receiving consulting fees from AbbVie, Amgen, Arena Pharmaceuticals, Boehringer Ingelheim, BMS, Celgene Corporation, Eli Lilly, Ferring Pharmaceuticals, Galmed Research, Genentech, Galxo Smith Kline, Japan Gastroenterological Endoscopy Society, Janssen Pharmaceuticals, Kaleido Biosciences, Imedex, Immunic, Iterative Scopes, Merck, Microba, Morgan, Lewis & Bockius LLP, Novartis, Otsuka Pharmaceutical Development PBM Capital, Pfizer, Protagonist Therapeutics Sanofi, Takeda, TiGenix, Vifor; and hold stock options in Intestinal Biotech Development. JT: Grant - AbbVie, Janssen Personal Fees - Pfizer, Janssen, Abbvie, sandoz.