Work

Evolution of surgical trends in Crohn’s disease during the biologic era: population-based cohort insights from Taiwan, a low-endemicity region

Year: 2025

Type: article

Abstract: BACKGROUND/AIMS: Surgery remains a crucial treatment option for Crohn's disease (CD), even with the introduction of biological agents. This nationwide cohort study in Taiwan investigates surgery trends and the impacts of biologics in a region with a low prevalence of CD. METHODS: This retrospective population-based cohort study used Taiwan's National Health Insurance Database from 2003 to 2018. The cohort included 725 CD patients. Patient characteristics, surgery outcomes, and impact of the biologic era on surgical risk were analyzed. RESULTS: During the study period, 292 CD patients (40.3%) underwent surgery, with 125 in the pre-biologic era and 167 in the post-biologic era. The incidences of intestinal surgery (IS) and perianal surgery (PS) have significantly decreased. The cumulative probabilities of IS were 20%, 35%, and 44% after 1, 5, and 10 years, respectively; the PS incidences were 3%, 5%, and 7%, respectively. The cumulative incidence of IS was significantly lower in the post-biologic era compared to the pre-biologic era (P= 0.049). CD patients had high second IS incidences of 31% at 5 years after the first IS. CONCLUSIONS: Our study demonstrates the surgical incidences have decreased in the biologic era but remained relatively high in a region with low disease prevalence. This suggests the need for further improvements in CD management.

Source: Intestinal Research

DOI: 10.5217/ir.2025.00003