It has been shown in clinic-based cohorts that there can be a significant change in disease behavior over time, whereas disease location remains relatively stable as per the Vienna classification system.
Clinical and environmental factors as well as medical therapy might be relevant in predicting disease behavior change in patients with CD. In previous studies, early age at diagnosis, disease location, perianal disease and, in some studies, smoking were associated with the presence of complicated disease and surgery.
The combined effect of markers of disease phenotype (e.g., age, gender, location, perianal diesease) and medical therapy (steroid use, early immunosupression) on the probability of disease behavior change were, however, not studied thus far in the published literature.
They found that perianal disease, current smoking, prior steroid use, early azathioprine or azathioprine/biological therapy are predictors of disease behavior change in CD patients.
The new data with easily applicable clinical information as presented in the article may assist clinicians in practical decision-making or in choosing the treatment strategy for their CD patients.