Early Course of Inflammatory Bowel Disease in a Population-Based Inception Cohort Study from 8 Countries in Asia and Australia

Siew C. Ng, Zhirong Zeng, Ola Niewiadomski, Whitney Tang, Sally Bell, Michael A. Kamm, Pinjin Hu, H. Janaka De Silva, Madunil A. Niriella, W. S.A.A.Yasith Udara, David Ong, Khoon Lin Ling, Choon Jin Ooi, Ida Hilmi, Khean Lee Goh, Qin Ouyang, Yu Fang Wang, Kaichun Wu, Xin Wang, Pises PisespongsaSathaporn Manatsathit, Satimai Aniwan, Julajak Limsrivilai, Jeffri Gunawan, Marcellus Simadibrata, Murdani Abdullah, Steve W.C. Tsang, Fu Hang Lo, Aric J. Hui, Chung Mo Chow, Hon Ho Yu, Mo Fong Li, Ka Kei Ng, Jessica Y.L. Ching, Victor Chan, Justin C.Y. Wu, Francis K.L. Chan, Minhu Chen, Joseph J.Y. Sung

Research output: Contribution to journalArticlepeer-review

60 Citations (Scopus)


Background & Aims The incidence of inflammatory bowel disease (IBD) is increasing in Asia, but little is known about disease progression in this region. The Asia-Pacific Crohn's and Colitis Epidemiology Study was initiated in 2011, enrolling subjects from 8 countries in Asia (China, Hong Kong, Indonesia, Sri Lanka, Macau, Malaysia, Singapore, and Thailand) and Australia. We present data from this ongoing study. Methods We collected data on 413 patients diagnosed with IBD (222 with ulcerative colitis [UC], 181 with Crohn's disease [CD], 10 with IBD unclassified; median age, 37 y) from 2011 through 2013. We analyzed the disease course and severity and mortality. Risks for medical and surgical therapies were assessed using Kaplan-Meier analysis. Results The cumulative probability that CD would change from inflammatory to stricturing or penetrating disease was 19.6%. The cumulative probabilities for use of immunosuppressants or anti-tumor necrosis factor agents were 58.9% and 12.0% for patients with CD, and 12.7% and 0.9% for patients with UC, respectively. Perianal CD was associated with an increased risk of anti-tumor necrosis factor therapy within 1 year of its diagnosis (hazard ratio, 2.97; 95% confidence interval, 1.09-8.09). The cumulative probabilities for surgery 1 year after diagnosis were 9.1% for patients with CD and 0.9% for patients with UC. Patients with CD and penetrating disease had a 7-fold increase for risk of surgery, compared with patients with inflammatory disease (hazard ratio, 7.67; 95% confidence interval, 3.93-14.96). The overall mortality for patients with IBD was 0.7%. Conclusions In a prospective population-based study, we found that the early course of disease in patients with IBD in Asia was comparable with that of the West. Patients with CD frequently progress to complicated disease and have accelerated use of immunosuppressants. Few patients with early stage UC undergo surgery in Asia. Increasing our understanding of IBD progression in different populations can help optimize therapy and improve outcomes.

Original languageEnglish
Pages (from-to)86-95.e3
Issue number1
Publication statusPublished - 1 Jan 2016


  • Natural History
  • Risk Factor
  • Treatment

Fingerprint Dive into the research topics of 'Early Course of Inflammatory Bowel Disease in a Population-Based Inception Cohort Study from 8 Countries in Asia and Australia'. Together they form a unique fingerprint.

Cite this