Title: Role of ASCA and the NOD2/CARD15 mutation Gly908Arg in predicting increased surgical costs in Crohn's disease patients: A project of the European Collaborative Study Group on Inflammatory Bowel Disease
Authors: Odes, Shmuel ×
Friger, Michael
Vardi, Hillel
Claessens, Greet
Bossuyt, Xavier
Riis, Lene
Munkholm, Pia
Wolters, Frank
Yona, Hagit
Hoie, Ole
Beltrami, Marina
Tsianos, Epameinondas
Katsanos, Kostas
Mouzas, Ioannis
Clofent, Juan
Monteiro, Estela
Messori, Andrea
Politi, Patrizia
O'morain, Colm
Limonard, Charles
Russel, Maurice
Vatn, Morten
Moum, Bjorn
Stockbrugger, Reinhold
Vermeire, Severine #
Issue Date: Jul-2007
Publisher: John Wiley & Sons
Series Title: Inflammatory Bowel Diseases vol:13 issue:7 pages:874-881
Abstract: Background:NOD2/CARD15, the first identified susceptibility gene in Crohn's disease (CD), is associated with ileal stenosis and increased frequency of surgery. Anti-Saccharomyces cerevisiae antibody (ASCA), a serological marker for CD, is associated with ileal location and a high likelihood for surgery. We hypothesized that the presence of ASCA and NOD2/CARD15 mutations could predict increased health care cost in CD.Methods: CD patients in a prospectively designed community-based multinational European and Israeli cohort (n = 228) followed for mean 8.3 (SD 2.6) years had blood drawn for measurement of ASCA (IgG, IgA), Arg702Trp, Gly908Arg, and Leu1007fsinsC. Days spent in the hospital and the costs of medical and surgical hospitalizations and medications were calculated.Results: The median duration of surgical hospitalizations was longer in Gly908Arg-positive than -negative patients, 3.5 and 1.5 days/patient-year (P < 0.01), and in ASCA-positive than -negative patients, 1.1 and 0 days/patient-year (P < 0.001). Median surgical hospitalization cost was 1,580 euro/patient-year in Gly908Arg-positive versus 0 euro/patient-year in -negative patients (P < 0.01), and 663 euro/patient-year in ASCA-positive versus 0 euro/patient-year in -negative patients (P < 0.001). Differences in cost of medications between groups were not significant. The effect of Gly908Arg was expressed in countries with higher Gly908Arg carriage rates. ASCA raised surgical costs independently of the age at diagnosis of disease. Arg702Trp and Leu1007fsinsC did not affect the cost of health care.Conclusions: Since CD patients positive for Gly908Arg and ASCA demonstrated higher health care costs, it is possible that measurement of Gly908Arg and ASCA at disease diagnosis can forecast the expensive CD patients.(Inflamm Bowel Dis 2007).
ISSN: 1078-0998
Publication status: published
KU Leuven publication type: IT
Appears in Collections:Laboratory of Clinical Bacteriology and Mycology
Translational Research in GastroIntestinal Disorders
Experimental Laboratory Immunology
× corresponding author
# (joint) last author

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