{
  "abstract": "Introduction Crohn’s disease (CD) progression can result in bowel damage (BD) and disability. Little is known about BD in early CD. The Crohn’s Disease Cohort (CROCO) is a multicentre prospective European study enrolling newly diagnosed CD patients (<1 year since diagnosis) to characterise BD and disability trajectories.Methods CROCO enrolled 539 newly diagnosed CD patients across 19 centres (median interval between diagnosis and inclusion: 3.7 months [IQR 1.5–7.3]). BD is assessed using the Lémann Index (LI) at years 1, 3, and 5 post-diagnosis (LI=0 defined as no BD; LI>0 as any BD). Using magnetic resonance imaging and endoscopy, BD is assessed using the Lémann Index (LI) at years 1(Y1), 3, and 5 after diagnosis. Absence of BD was defined as LI=0, and any BD as LI>0. We report BD at Y1 and the IBD-Disability index (IBD-DI).Results 539 patients were enrolled, the median interval between diagnosis and inclusion was 3.7 months (IQR 1.5–7.3). Complete Lémann Index (LI) data was captured in 415 patients [57% male; median age 35 years (IQR 25–50)]. At inclusion, 89% had ileal or ileocolonic disease, 73% an inflammatory phenotype, and 8% perianal involvement.Within six months of diagnosis, 18% received 5ASA, 30% systemic corticosteroids, 36% immunosuppressants, and 61% advanced therapy (AT) (91% antiTNF). Median time to AT initiation was 3.5 months (IQR 1.4–5.7), with 48% commencing treatment within six months. Overall, 64% demonstrated some degree of bowel damage (LI > 0), although the median LI remained low [0.6 (IQR 0–1)].Univariate analysis identified colonic disease (L2) as protective against bowel damage (p = 0.012). B2/B3 behaviour (p < 0.001) and perianal disease (p = 0.005) were associated with bowel damage at Y1. In multivariate analysis, only B2/B3 behaviour (p < 0.001) and perianal disease (p = 0.008) remained independently associated.No association was observed between bowel damage and moderatetosevere disability (OR 1.06, 95% CI 0.52–2.15, p = 0.88).Conclusions In this cohort of newly diagnosed CD patients, two-thirds demonstrated BD evidence at one year. Isolated colonic disease was protective against development of BD. No association was found between BD and disability.Abstract P203 Table 1Association between the Lémann index at Y1Multivariate logistic regression modelVariablesOR (95% CI)p-valueDisease location L1/L3: ileal/ileocolonic L2: colonic0.49 (0.17 to 1.28)0.15Disease behaviour B1 B2/B31.0014.08 (5.57 to 45.2)<0.0001Perianal disease5.5 (1.51 to 29.63)0.008Treatment category in the first 6 months No medical treatment 5ASA monotherapy Steroids (excluding topical steroids) ISS monotherapy Advanced therapy Enteral nutrition or Crohn’s disease exclusive diet monotherapy1.000.35 (0.07 to 1.76)0.3 (0.09 to 0.88)0.22 (0.05 to 0.82)0.33 (0.1 to 0.93)2.58 (0.2 to 367.69)0.11",
  "authors": [
    {
      "affiliations": [
        "St Marks Academic Institute, St Marks Hospital, London, United Kingdom"
      ],
      "name": "Adam Fadra"
    },
    {
      "affiliations": [
        "Division of Gastroenterology, Hospital Beatriz Ângelo, Loures, Portugal",
        "Division of Gastroenterology, Hospital da Luz, Lisbon, Portugal"
      ],
      "name": "Joana Revés"
    },
    {
      "affiliations": [
        "Gastrounit medical division, Copenhagen University Hospital, Denmark"
      ],
      "name": "Gorm Roager Madsen"
    },
    {
      "affiliations": [
        "IBD Research Unit, Department of Gastroenterology, Hull University Teaching Hospitals, Hull, United Kingdom"
      ],
      "name": "Jessica Thut"
    },
    {
      "affiliations": [
        "Gastrounit medical division, Copenhagen University Hospital, Denmark"
      ],
      "name": "Johan Burisch"
    },
    {
      "affiliations": [
        "IBD Unit, CHU Clermont-Ferrand, Clermont-Ferrand, France"
      ],
      "name": "Marie Bonnet-Dodel"
    },
    {
      "affiliations": [
        "Division of Gastroenterology, Hospital da Luz, Lisbon, Portugal"
      ],
      "name": "Marilia Cravo"
    },
    {
      "affiliations": [
        "St Marks Academic Institute, St Marks Hospital, London, United Kingdom"
      ],
      "name": "Lucy Monin"
    },
    {
      "affiliations": [
        "Department of Gastroenterology, Hospital Clinic Barcelona, Barcelona, Spain"
      ],
      "name": "Agnes Fernandez-Clotet"
    },
    {
      "affiliations": [
        "Gastroenterology and Hepatology, American Gastroenterology Center, Strovolos, Cyprus"
      ],
      "name": "Ioannis Kaimakiotis"
    },
    {
      "affiliations": [
        "Department of Gastroenterology, University Hospital CHU of Liège, Liège, Belgium"
      ],
      "name": "Sophie Vieujean"
    },
    {
      "affiliations": [
        "Department of Gastroenterology, University Hospital CHU of Liège, Liège, Belgium"
      ],
      "name": "Catherine Van Kemseke"
    },
    {
      "affiliations": [
        "Department of Gastroenterology, Mater Dei Hospital, Msida, Malta"
      ],
      "name": "Pierre Ellul"
    },
    {
      "affiliations": [
        "Department of Gastroenterology, Mater Dei Hospital, Msida, Malta"
      ],
      "name": "Kelly Conti"
    },
    {
      "affiliations": [
        "Gastroenterology, IBD Clinical and Research Clinic, ISCARE, Czech Republic"
      ],
      "name": "Dana Duricova"
    },
    {
      "affiliations": [
        "Department of Gastroenterology, Hospital Universitario de Galdakao, Galdakao, Spain"
      ],
      "name": "Iago Rodríguez-Lago"
    },
    {
      "affiliations": [
        "Department of Gastroenterology, Hospital Clinic Barcelona, Barcelona, Spain"
      ],
      "name": "Ingrid Ordas"
    },
    {
      "affiliations": [
        "IBD Research Unit, Department of Gastroenterology, Hull University Teaching Hospitals, Hull, United Kingdom"
      ],
      "name": "Sebastian Shaji"
    },
    {
      "affiliations": [
        "Department of Gastroenterology, Hospital Garcia de Orta, Almada, Portugal"
      ],
      "name": "Irina Mocanu"
    },
    {
      "affiliations": [
        "Gastroenterology, Hospital Alvaro Cunqueiro, Vigo, Spain"
      ],
      "name": "Vincent Hernandez"
    },
    {
      "affiliations": [
        "Department of Hepato-Gastroenterology, CHU Amiens-Picardie Hôpital Sud, Amien, France"
      ],
      "name": "Mathurin Fumery"
    },
    {
      "affiliations": [
        "Univ. Lille, Inserm, CHU Lille, U1286 – INFINITE, Institute for Translational Research in Inflammation, Lille, France"
      ],
      "name": "Maria Nachury"
    },
    {
      "affiliations": [
        "St Marks Academic Institute, St Marks Hospital, London, United Kingdom"
      ],
      "name": "Natalia Pedersen"
    },
    {
      "affiliations": [
        "Instituto Português de Oncologia, Lisboa, Portugal"
      ],
      "name": "Daniel Conceição"
    },
    {
      "affiliations": [
        "Gastroenterology, Algomed Policlinic, Timisoara, Romania"
      ],
      "name": "Adrian Goldis"
    },
    {
      "affiliations": [
        "Investigation Center, Hospital da Luz Learning Health, Lisbon, Portugal"
      ],
      "name": "Ana Guedes"
    },
    {
      "affiliations": [
        "Investigation Center, Hospital da Luz Learning Health, Lisbon, Portugal"
      ],
      "name": "Raquel Ribeiro"
    },
    {
      "affiliations": [
        "Department of Gastroenterology, Mount Sinai Hospital, New York, USA"
      ],
      "name": "Ryan Ungaro"
    },
    {
      "affiliations": [
        "ECSTRRA Unit, Centre of Research in Epidemiology and Statistics, Paris, France"
      ],
      "name": "Noemie Bigot"
    },
    {
      "affiliations": [
        "ECSTRRA Unit, Centre of Research in Epidemiology and Statistics, Paris, France"
      ],
      "name": "Jean-Yves Mary"
    },
    {
      "affiliations": [
        "ECSTRRA Unit, Centre of Research in Epidemiology and Statistics, Paris, France"
      ],
      "name": "Jérôme Lambert"
    },
    {
      "affiliations": [
        "Department of Gastroenterology, Mount Sinai Hospital, New York, USA"
      ],
      "name": "Jean-Frédéric Jean-Frédéric"
    },
    {
      "affiliations": [
        "IBD Unit, CHU Clermont-Ferrand, Clermont-Ferrand, France"
      ],
      "name": "Anthony Buisson"
    },
    {
      "affiliations": [
        "Division of Gastroenterology, Hospital Beatriz Ângelo, Loures, Portugal",
        "Division of Gastroenterology, Hospital da Luz, Lisbon, Portugal",
        "Investigation Center, Hospital da Luz Learning Health, Lisbon, Portugal"
      ],
      "name": "Joana Torres"
    },
    {
      "affiliations": [
        "St Marks Academic Institute, St Marks Hospital, London, United Kingdom",
        "Department of Metabolism, Digestion and Reproduction, Imperial College, London, United Kingdom"
      ],
      "name": "Naila Arebi"
    }
  ],
  "title": "P203 Bowel damage in a cohort of recently diagnosed crohn’s disease patients: results from the crohn´s disease cohort study",
  "uid": "f42de823-c420-5f4b-996b-c733ebb17c05"
}