Comparison of clinical characteristics and management of inflammatory bowel disease in Hong Kong versus Melbourne

Prideaux, Lani; Kamm, Michael A.; Cruz, Peter De; Williams, James S.; Bell, Sally; Connell, William; Brown, Steven J; Lust, Mark; Desmond, Paul; Chan, H.L.-Y.; Chow, Dorothy K.; Wu, Justin C.Y.; Leong, Rupert W.; Sung, Joseph J.Y.; Chan, Francis K.L.; Ng, Siew C.

doi:10.1111/j.1440-1746.2011.06984.x

Cited by 33 publications

(46 citation statements)

References 49 publications

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“…The disease severity in Asian CD patients was also comparable to that reported in Australia, with an even higher rate of penetrating disease and perianal disease at diagnosis noted in Asia [1]. This is contrary to previous notions that IBD runs a milder disease course in Asia [14]. …”

Section: Disease Phenotypecontrasting

confidence: 53%

“…For CD, the use of anti-TNFα agents (39.9 vs. 11.0%, p < 0.001) was more common in Melbourne than in HK. This was also true for UC, although only a small number of patients, 12 of 159 patients in Melbourne and 2 of 203 patients in HK were on these agents [14]. The underuse of anti-TNFα agents in Asia may be related to various factors, including clinicians' lack of experience with the therapy, high cost, lack of insurance reimbursement, and concern for opportunistic infections [34].…”

Section: Treatment and Managementmentioning

confidence: 99%

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The Same Intestinal Inflammatory Disease despite Different Genetic Risk Factors in the East and West?

Lui

2016

Inflamm Intest Dis

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Background: Inflammatory bowel disease (IBD) is a chronic inflammatory disease with unknown etiology. It is likely caused by a complex interplay between genetic, immunologic and environmental factors. Although IBD is still relatively uncommon in Asia, a multitude of studies have shown that it is an emerging disease around the world. Recent insights have highlighted both the similarities and differences amongst Asian and Western IBD patients. Summary: The annual incidence of IBD in the East is still low compared with the West, but there are differences between different regions of Asia. Time trend studies have shown that the incidence of IBD is on the rise. Some notable differences in the clinical manifestations of IBD between the East and West have also been noted. ‘Westernization' of lifestyle may encompass various social and environmental changes that account for the emergence of IBD in our population, although genetics also plays a role in disease pathogenesis. Diagnosis and treatment challenges include limited access to medical care in certain areas, limited availability and high cost of medications, lack of insurance reimbursement, paucity of multidisciplinary teams for the management of complicated IBD cases, and a high prevalence of endemic infections. Currently, the risk of colorectal cancer is lower in the East than in the West, but cancer rates will likely approach that of the West in the future as the prevalence of IBD continues to rise. Key Messages: Measures to improve access to diagnostic tools, increase the availability of medication, and provide adequate multidisciplinary care for IBD patients will become increasingly important in Asia. Differences between the East and West will provide a unique opportunity for global collaboration in basic and clinical research to further our understanding of the disease entity and also provide more locoregional data to healthcare providers and policymakers to make informed decisions and policy changes when tackling the rising burden of IBD in Asia.

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Section: Disease Phenotypecontrasting

confidence: 53%

Section: Treatment and Managementmentioning

confidence: 99%

The Same Intestinal Inflammatory Disease despite Different Genetic Risk Factors in the East and West?

Lui

2016

Inflamm Intest Dis

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“…Alternative explanations include differences in genetic makeup and/or environmental exposure (e.g., type of tobacco, way of smoking). It is likely that smoking does not cause CD but modulates the disease once present 35. Furthermore, smoking in CD may not play the same role in different ethnic groups as it does in Western populations due to differences in genetic heterogeneity.…”

Section: Resultsmentioning

confidence: 99%

Environmental risk factors in inflammatory bowel disease: a population-based case-control study in Asia-Pacific

Tang²,

Leong

et al. 2014

Gut

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368

287

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“…One study in China was not able to demonstrate an association 65. In a cross-sectional observational study, there were fewer smokers among Chinese with CD in Hong Kong than Caucasians with CD in Melbourne, Australia 66. More studies are needed in Asia (a high smoking area) to determine the impact of smoking on the development and progression of CD and its association with disease phenotype.…”

Section: Environmental Factorsmentioning

confidence: 99%

Geographical variability and environmental risk factors in inflammatory bowel disease

Bernstein

Vatn

et al. 2013

Gut

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506

332

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The changing epidemiology of inflammatory bowel disease (IBD) across time and geography suggests that environmental factors play a major role in modifying disease expression. Disease emergence in developing nations suggests that epidemiological evolution is related to westernisation of lifestyle and industrialisation. The strongest environmental associations identified are cigarette smoking and appendectomy, although neither alone explains the variation in incidence of IBD worldwide. Urbanisation of societies, associated with changes in diet, antibiotic use, hygiene status, microbial exposures and pollution have been implicated as potential environmental risk factors for IBD. Changes in socioeconomic status might occur differently in different geographical areas and populations and, consequently, it is important to consider the heterogeneity of risk factors applicable to the individual patient. Environmental risk factors of individual, familial, community-based, country-based and regionally based origin may all contribute to the pathogenesis of IBD. The geographical variation of IBD provides clues for researchers to investigate possible environmental aetiological factors. The present review aims to provide an update of the literature exploring geographical variability in IBD and to explore the environmental risk factors that may account for this variability.

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Comparison of clinical characteristics and management of inflammatory bowel disease in Hong Kong versus Melbourne

Cited by 33 publications

References 49 publications

The Same Intestinal Inflammatory Disease despite Different Genetic Risk Factors in the East and West?

The Same Intestinal Inflammatory Disease despite Different Genetic Risk Factors in the East and West?

Environmental risk factors in inflammatory bowel disease: a population-based case-control study in Asia-Pacific

Geographical variability and environmental risk factors in inflammatory bowel disease

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