The following is a summary of “Baseline Clinical Factors Are Associated With Risk of Complications in Crohn’s Disease: Appraisal of the American Gastroenterological Association Clinical Care Pathway,” published in the January 2024 issue of Gastroenterology by Santiago, et al.

The American Gastroenterological Association (AGA) has outlined risk factors deemed predictive of disease complications in Crohn’s disease (CD) and ulcerative colitis (UC). For a study, researchers sought to assess the efficacy of AGA risk factors in stratifying the risk of complications in UC and CD.

Participants from two cohorts, the Ocean State Crohn’s and Colitis Area Registry cohort and the Mayo Clinic cohort, were included. Baseline clinical risk factors were collected based on the AGA pathway. The primary endpoint encompassed inflammatory bowel disease-related hospitalization, bowel surgery, or disease progression. The association between the number of AGA risk factors and the endpoint was analyzed. Cox proportional hazard models were employed for statistical multivariable modeling.

The study included 412 CD patients. A comparison of ≥3 risk factors with 0–1 risk factor revealed a significantly heightened risk of complications in both cohorts: Ocean State Crohn’s and Colitis Area Registry (HR 2.75, 95% CI 1.71–4.41) and Mayo Clinic (HR 2.07, 95% CI 1.11–3.84). Specific factors significantly associated with complications in CD included younger age at diagnosis (HR 2.07), perianal disease (HR 1.99), and B2/B3 behavior (HR 1.92). However, there was no consistent association observed between the number of risk factors or specific individual risk factors and the risk of complications in the 265 UC patients included.

A significant association was identified between the number of AGA risk factors and the risk of disease complications in CD, highlighting the utility of the AGA care pathway in stratifying CD patients at higher risk of complications. However, the association was not consistently observed in UC, suggesting potential differences in predictive factors between the two diseases.

Source: journals.lww.com/ajg/abstract/2024/01000/baseline_clinical_factors_are_associated_with_risk.22.aspx