Gut Liver.  2016 Jul;10(4):595-603. 10.5009/gnl15411.

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

• Kwon JH
• Im JP
• Ye BD
• Cheon JH
• Jang HJ
• Lee KM
• Kim YS
• Kim SW
• Kim YH
• Song GA
• Han DS
• Kim WH
• Kim JS

• KMID: 2412049
• DOI: http://doi.org/10.5009/gnl15411

Abstract

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.

Keyword

Crohn disease; C-reactive protein; Clinical course

MeSH Terms

Adolescent
Adult
Anti-Inflammatory Agents, Non-Steroidal/therapeutic use
Biomarkers/blood
C-Reactive Protein/*analysis
Colon/pathology
Colonoscopy
Constriction, Pathologic
Crohn Disease/*blood/drug therapy/pathology
Disease Progression
Female
Hospitalization/statistics & numerical data
Humans
Ileum/pathology
Immunosuppressive Agents/therapeutic use
Male
Phenotype
Predictive Value of Tests
Prognosis
Retrospective Studies
*Severity of Illness Index
Young Adult
Anti-Inflammatory Agents, Non-Steroidal
Biomarkers
Immunosuppressive Agents
C-Reactive Protein