Evidence map›Paper›PMID 37422727›Full record

ArticleJournal of Crohn's & colitis2023

Declining Trends of Reoperations and Disease Behaviour Progression in Crohn's Disease over Different Therapeutic Eras-A Prospective, Population-Based Study from Western Hungary between 1977-2020, Data from the Veszprem Cohort.

Lorant Gonczi, Laszlo Lakatos, Petra A Golovics, Akos Ilias, Tunde Pandur, Gyula David, Zsuzsanna Erdelyi, Istvan Szita, Alex Al Khoury, Peter L Lakatos

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of Crohn's & colitis, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
2.8field-weighted citation impact, top 9% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 9 citations in OpenAlex.

  1. Article
  2. Review
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  4. Review
  5. Article
  6. Observational
  7. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 3 institutions in 2 countries.

Lorant GoncziDepartment of Internal Medicine and Oncology, Semmelweis University, Budapest, Hungary.
Laszlo LakatosDepartment of Gastroenterology, Ferenc Csolnoky Hospital, Veszprem, Hungary.
Petra A GolovicsDepartment of Gastroenterology, Hungarian Defence Forces Medical Centre, Budapest, Hungary.
Akos IliasDepartment of Internal Medicine and Oncology, Semmelweis University, Budapest, Hungary.
Tunde PandurDepartment of Gastroenterology, Grof Eszterhazy Hospital, Papa, Hungary.
Gyula DavidDepartment of Gastroenterology, Ferenc Csolnoky Hospital, Veszprem, Hungary.
Zsuzsanna ErdelyiDepartment of Gastroenterology, Ferenc Csolnoky Hospital, Veszprem, Hungary.
Istvan SzitaDepartment of Gastroenterology, Ferenc Csolnoky Hospital, Veszprem, Hungary.
Alex Al KhouryGastro Health, LLC-Care Center, Hollywood, FL, USA.
Peter L LakatosDepartment of Internal Medicine and Oncology, Semmelweis University, Budapest, Hungary.ORCID 0000-0002-3948-6488
Semmelweis University · HUEszterhazy Karoly Catholic University · HUZrínyi Miklós National Defence University · HU

Funding

Source of the National Research, Development and Innovation Fund
6 · The paper itself

Abstract

BACKGROUND AND

aimsFew population-based studies have investigated long-term surgery rates for Crohn's disease [CD]. Our aim was to analyse disease progression and surgery rates in a population-based cohort over different therapeutic eras, based on the time of diagnosis: cohort-A [1977-1995], cohort-B [1996-2008], and cohort-C [2009-2018].

methodsA total of 946 incident CD patients were analysed (male/female: 496/450; median age at diagnosis: 28 years [y]; interquartile range [IQR]: 22-40]). Patient inclusion lasted between 1977 and 2018. Immunomodulators have become widespread in Hungary since the mid-1990s and biologic therapies since 2008. Patients were followed prospectively, with both in-hospital and outpatient records reviewed regularly.

resultsThe probability of disease behaviour progression from inflammatory [B1] to stenosing or penetrating phenotype [B2/B3] significantly decreased (27.1 ± 5.3%/21.5 ± 2.5%/11.3 ± 2.2% in cohorts A/B/C, respectively, after 5 years; 44.3 ± 5.9%/30.6 ± 2.8%/16.1 ± 2.9% after 10 years, respectively; [pLogRank <0.001]). The probability of first resective surgery between cohorts A/B/C were 33.3 ± 3.8%/26.5 ± 2.1%/28.1 ± 2.4%, respectively, after 5 years; 46.1 ± 4.1%/32.6 ± 2.2%/33.0 ± 2.7% after 10 years, respectively; and 59.1 ± 4.0%/41.4 ± 2.6% [cohorts A/B] after 20 years. There was a significant decrease in first resective surgery risk between cohorts A and B [plog rank = 0.002]; however, no further decrease between cohorts B and C [plog rank = 0.665]. The cumulative probability of re-resection in cohorts A/B/C was decreasing over time (17.3 ± 4.1%/12.6 ± 2.6%/4.7 ± 2.0%, respectively, after 5 years [plog rank = 0.001]).

conclusionWe report a continuous decline in reoperation rates and disease behaviour progression in CD over time, with the lowest values in the biologic era. In contrast, there was no further decrease in the probability of first major resective surgery after the immunosuppressive era.

Indexed as

Crohn DiseaseAdultDisease ProgressionFemaleHumansHungaryImmunosuppressive AgentsMaleProspective StudiesReoperationRetrospective StudiesImmunosuppressive AgentsbiologicsCrohn’s diseaseimmunomodulatorspopulation-basedresective surgery

Identifiers

PMID37422727
PMCPMC10798863
OpenAlexW4383670165

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.