The role of CARD15 mutations and smoking in the course of Crohn's disease in a Mediterranean area

Maria Concetta Renda, Ambrogio Orlando, Giuseppe Civitavecchia, Valeria Criscuoli, Aurelio Maggio, Filippo Mocciaro, Francesca Rossi, Daniela Scimeca, Irene Modesto, Lorenzo Oliva, Mario Cottone

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Abstract

AIM: To evaluate the role of CARD15 mutations and smoking in the main events of Crohn's disease (CD). PATIENTS AND METHODS: A total of 182 patients with CD were included in a prospective study in order to evaluate the role of CARD15 mutations and smoking in the main outcomes of disease course: first operation and surgical recurrence. The following variables were evaluated in a univariable and multivariable analysis: age, sex, site of disease, pattern, smoking habit, extraintestinal manifestations, duration of disease, and CARD15 mutation. The Kaplan-Meier method for survival curves and Cox model for multivariable analysis were, respectively, used. RESULTS: A total of 110 patients were operated on and 32 were reoperated on. The 7-yr cumulative free rate of surgery was 42% (95% CI 34-51%). At multivariate analysis only stricturing and penetrating pattern were predictors of surgery (HR 1.7, 95% CI 1-2.8; HR 3.2, CI 1.8-5.5, respectively). The 7-yr cumulative free rate of reoperation was 75% (95% CI 0.52-0.88). At multivariable analysis in the model with any CARD15 mutation, only smoking habit at diagnosis (HR 3.6, 95% CI 1.4-9.1) was predictive of surgical recurrence. When single mutations were considered in the model smoking (HR 4.2, 95% CI 1.8-10.1) and L1007fs mutation (HR 2.9, 95% CI 1.1-7.3) were predictive of reoperation. CONCLUSIONS: In CD, smoking predicts recurrence after surgery. The role of CARD15 mutations in the clinical course of CD remains undefined.

Original languageEnglish
Pages (from-to)649-655
Number of pages7
JournalAmerican Journal of Gastroenterology
Volume103
Issue number3
DOIs
Publication statusPublished - Mar 2008

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ASJC Scopus subject areas

  • Gastroenterology

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Renda, M. C., Orlando, A., Civitavecchia, G., Criscuoli, V., Maggio, A., Mocciaro, F., Rossi, F., Scimeca, D., Modesto, I., Oliva, L., & Cottone, M. (2008). The role of CARD15 mutations and smoking in the course of Crohn's disease in a Mediterranean area. American Journal of Gastroenterology, 103(3), 649-655. https://doi.org/10.1111/j.1572-0241.2007.01589.x