Browsing by Author "Ching, J.Y."

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    Early course of inflammatory bowel disease in a population-based Inception cohort study from 8 countries in Asia and Australia
    (Baltimore, 2016) Ng, S.C.; Zeng, Z.; Niewiadomski, O.; Tang, W.; Bell, S.; Kamm, M.A.; Hu, P.; de Silva, H.J.; Niriella, M.A.; Udara, W.Y.; Ong, D.; Ling, K.L.; Ooi, C.J.; Hilmi, I.; Goh, K.L.; Ouyang, Q.; Wang, Y.F.; Wu, K.; Wang, X.; Pisespongsa, P.; Manatsathit, S.; Aniwan, S.; Limsrivilai, J.; Gunawan, J.; Simadibrata, M.; Abdullah, M.; Tsang, S.W.; Lo, F.H.; Hui, A.; Chow, C.M.; Yu, H.H.; Li, M.F.; Ng, K.K.; Ching, J.Y.; Chan, V.; Wu, J.C.; Chan, F.K.; Chen, M.; Sung, J.J.; Asia-Pacific Crohn's and Colitis Epidemiology Study (ACCESS) Group
    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 IBD unclassified [IBDU]; median age, 37 years) from 2011 through 2013. We analyzed 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 (TNF) 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-TNF therapy within 1 year of its diagnosis (HR, 2.97; 95% CI, 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 to patients with inflammatory disease (HR, 7.67; 95% CI, 3.93–14.96). Overall mortality for patients with IBD was 0.7%. Conclusion: In a prospective population-based study, we found that the early course of disease in patients with IBD in Asia was comparable to 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.
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    Incidence and phenotype of inflammatory bowel disease based on results from the Asia-pacific Crohn's and colitis epidemiology study
    (Elsevier-W.B. Saunders, 2013) Ng, S.C.; Tang, W.; Ching, J.Y.; Wong, M.; Chow, C.M.; Hui, A.J.; Wong, T.C.; Leung, V.K.; Tsang, S.W.; Yu, H.H.; Li, M.F.; Ng, K.K.; Kamm, M.A.; Studd, C.; Bell, S.; Leong, R.; de Silva, H.J.; Kasturiratne, A.; Mufeena, M.N.; Ling, K.L.; Ooi, C.J.; Tan, P.S.; Ong, D.; Goh, K.L.; Hilmi, I.; Pisespongsa, P.; Manatsathit, S.; Rerknimitr, R.; Aniwan, S.; Wang, Y.F.; Ouyang, Q.; Zeng, Z.; Zhu, Z.; Chen, M.H.; Hu, P.J.; Wu, K.; Wang, X.; Simadibrata, M.; Abdullah, M.; Wu, J.C.; Sung, J.J.; Chan, F.K.; Asia-Pacific Crohn's and Colitis Epidemiologic Study (ACCESS) Study Group
    BACKGROUND & AIMS: Inflammatory bowel diseases (IBD) are becoming more common in Asia, but epidemiologic data are lacking. The Asia Pacific Crohn's and Colitis Epidemiology Study aimed to determine the incidence and phenotype of IBD in 8 countries across Asia and in Australia. METHODS: We performed a prospective, population-based study of IBD incidence in predefined catchment areas, collecting data for 1 year, starting on April 1, 2011. New cases were ascertained from multiple overlapping sources and entered into a Web-based database. Cases were confirmed using standard criteria. Local endoscopy, pathology, and pharmacy records were searched to ensure completeness of case capture. RESULTS: We identified 419 new cases of IBD (232 of ulcerative colitis [UC], 166 of Crohn's disease [CD], and 21 IBD-undetermined). The crude annual overall incidence values per 100,000 individuals were 1.37 for IBD in Asia (95% confidence interval: 1.25-1.51; 0.76 for UC, 0.54 for CD, and 0.07 for IBD-undetermined) and 23.67 in Australia (95% confidence interval: 18.46-29.85; 7.33 for UC, 14.00 for CD, and 2.33 for IBD-undetermined). China had the highest incidence of IBD in Asia (3.44 per 100,000 individuals). The ratios of UC to CD were 2.0 in Asia and 0.5 in Australia. Median time from symptom onset to diagnosis was 5.5 months (interquartile range, 1.4-15 months). Complicated CD (stricturing, penetrating, or perianal disease) was more common in Asia than Australia (52% vs 24%; P = .001), and a family history of IBD was less common in Asia (3% vs 17%; P < .001). CONCLUSIONS: We performed a large-scale population-based study and found that although the incidence of IBD varies throughout Asia, it is still lower than in the West. IBD can be as severe or more severe in Asia than in the West. The emergence of IBD in Asia will result in the need for specific health care resources, and offers a unique opportunity to study etiologic factors in developing nations.