Browsing by Author "Ong, D."

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The Association between new generation oral contraceptive pill and the development of inflammatory bowel diseases
(Korean Association for the Study of Intestinal Diseases, 2018) Sanagapalli, S.; Ko, Y.; Kariyawasam, V.; Ng, S.C.; Tang, W.; de Silva, H.J.; Chen, M.; Wu, K.; Aniwan, S.; Ng, K.K.; Ong, D.; Ouyang, Q.; Hilmi, I.; Simadibrata, M.; Pisespongsa, P.; Gopikrishna, S.; Leong, R.W.; IBD Sydney Organization and the asia-Pacific Crohn's Epidemiology Study (ACCESS) Group
BACKGROUND/AIMS: To examine the association between use of oral contraceptive pills (OCPs) and the risk of developing inflammatory bowel diseases (IBD), in a modern cohort. METHODS: A prospective nested case-control study across sites in the Asia-Pacific region was conducted; involving female IBD cases and asymptomatic controls. Subjects completed a questionnaire addressing questions related to OCP use. Primary outcome was the risk of development of IBD of those exposed to OCP versus non-exposure. Secondary outcomes were development of Crohn's disease (CD) versus ulcerative colitis (UC), and whether age of first use of OCP use may be associated with risk of IBD. RESULTS: Three hundred and forty-eight female IBD cases (41% CD, median age: 43 years) and 590 female age-matched controls were recruited. No significant association was found between OCP use and the risk of IBD (odds ratio [OR], 1.65; 95% confidence interval, 0.77-3.13; P=0.22), CD (OR, 1.55) or UC (OR, 1.01). The lack of association persisted when results were adjusted for age and smoking. IBD cases commenced OCP use at a younger age than controls (18 years vs. 20 years, P=0.049). CONCLUSIONS: In this large cohort of subjects from the Asia-Pacific region, we found a modest but not significantly increased risk of developing IBD amongst OCP users.
Best practices on immunomodulators and biological agents for ulcerative colitis and Crohn's disease in Asia.
(Taehan Chang Yŏn'gu Hakhoe, 2019) Ooi, C.J.; Hilmi, I.; Banerjee, R.; Chuah, S.W.; Ng, S.C.; Wei, S.C.; Makharia, G.K.; Pisespongsa, P.; Chen, M.H.; Ran, Z.H.; Ye, B.D.; Park, D.I.; Ling, K.L.; Ong, D.; Ahuja, V.; Goh, K.L.; Sollano, J.; K.Lim, W.C.; Leung, W.; Raja Ali, R.A.; Wu, D.C.; Ong, E.; Mustaffa, N.; Limsrivilai, J.; Hisamatsu, T.; Yang, S.K.; Ouyang, Q.; Geary, R.; de Silva, H.J.; Rerknimitr, R.; Simadibrata, M.; Abdullah, M.; Leong, R.W.L.; Asia Pacific Association of Gastroenterology (APAGE) Working Group on Inflammatory Bowel Disease and Asian Organization for Crohn's and Colitis
ABSTRACT: The Asia-Pacific Working Group on inflammatory bowel disease (IBD) was established in Cebu, Philippines, under the auspices of the Asian Pacific Association of Gastroenterology with the goal of improving IBD care in Asia. This consensus is carried out in collaboration with Asian Organization for Crohn's and Colitis. With biologic agents and biosimilars becoming more established, it is necessary to conduct a review on existing literature and establish a consensus on when and how to introduce biologic agents and biosimilars in the conjunction with conventional treatments for ulcerative colitis (UC) and Crohn's disease (CD) in Asia. These statements also address how pharmacogenetics influence the treatments of UC and CD and provide guidance on response monitoring and strategies to restore loss of response. Finally, the review includes statements on how to manage treatment alongside possible hepatitis B and tuberculosis infections, both common in Asia. These statements have been prepared and voted upon by members of IBD workgroup employing the modified Delphi process. These statements do not intend to be all-encompassing and future revisions are likely as new data continue to emerge.
Best practices on immunomodulators and biological agents for ulcerative colitis and Crohn's disease in Asia.
(Blackwell Scientific Publications, 2019) Ooi, C. J.; Hilmi, I.; Banerjee, R.; Chuah, S.W.; Ng, S.C; Wei, S.C.; Makharia, G.K.; Pisespongsa, P.; Chen, M.H.; Ran, Z.H.; Ye, B.D.; Park, D. I.; Ling, K. L.; Ong, D.; Ahuja, V.; Goh, K.L.; Sollano, J.; K.Lim, W.C.; Leung, W.; Raja Ali, R.A.; Wu, D.C.; Ong, E; Mustaffa, N.; Limsrivilai, J.; Hisamatsu, T.; Yang, S. K.; Ouyang, Q.; Geary, R.; de Silva, H.J.; Rerknimitr, R.; Simadibrata, M.; Abdullah, M.; Leong, R.W.L.; Asia Pacific Association of Gastroenterology (APAGE) Working Group on Inflammatory Bowel Disease and Asian Organization for Crohn's and Colitis
The Asia Pacific Working Group on Inflammatory Bowel Disease (IBD) was established in Cebu, Philippines, under the auspices of the Asian Pacific Association of Gastroenterology (APAGE) with the goal of improving IBD care in Asia. This consensus is carried out in collaboration with Asian Organization for Crohn's and Colitis (AOCC). With biological agents and biosimilars becoming more established, it is necessary to conduct a review on existing literature and establish a consensus on when and how to introduce biological agents and biosimilars in the conjunction with conventional treatments for ulcerative colitis (UC) and Crohn's disease (CD) in Asia. These statements also address how pharmacogenetics influence the treatments of UC and CD and provide guidance on response monitoring and strategies to restore loss of response. Finally, the review includes statements on how to manage treatment alongside possible Hepatitis B and tuberculosis infections, both common in Asia. These statements have been prepared and voted upon by members of IBD workgroup employing the modified Delphi process. These statements do not intend to be all-encompassing and future revisions are likely as new data continue to emerge.
Early course of inflammatory bowel disease in a population-based Inception cohort study from 8 countries in Asia and Australia
(Baltimore, 2016) Ng, S.C.; Zeng, Z.; Niewiadomski, O.; Tang, W.; Bell, S.; Kamm, M.A.; Hu, P.; de Silva, H.J.; Niriella, M.A.; Udara, W.Y.; Ong, D.; Ling, K.L.; Ooi, C.J.; Hilmi, I.; Goh, K.L.; Ouyang, Q.; Wang, Y.F.; Wu, K.; Wang, X.; Pisespongsa, P.; Manatsathit, S.; Aniwan, S.; Limsrivilai, J.; Gunawan, J.; Simadibrata, M.; Abdullah, M.; Tsang, S.W.; Lo, F.H.; Hui, A.; Chow, C.M.; Yu, H.H.; Li, M.F.; Ng, K.K.; Ching, J.Y.; Chan, V.; Wu, J.C.; Chan, F.K.; Chen, M.; Sung, J.J.; Asia-Pacific Crohn's and Colitis Epidemiology Study (ACCESS) Group
Background & Aims: The incidence of inflammatory bowel disease (IBD) is increasing in Asia, but little is known about disease progression in this region. The Asia-Pacific Crohn’s and Colitis Epidemiology Study was initiated in 2011, enrolling subjects from 8 countries in Asia (China, Hong Kong, Indonesia, Sri Lanka, Macau, Malaysia, Singapore, and Thailand) and Australia. We present data from this ongoing study. Methods: We collected data on 413 patients diagnosed with IBD (222 with ulcerative colitis [UC)], 181 with Crohn’s disease [CD], 10 IBD unclassified [IBDU]; median age, 37 years) from 2011 through 2013. We analyzed disease course and severity and mortality. Risks for medical and surgical therapies were assessed using Kaplan-Meier analysis. Results: The cumulative probability that CD would change from inflammatory to stricturing or penetrating disease was 19.6%. The cumulative probabilities for use of immunosuppressants or anti-tumor necrosis factor (TNF) agents were 58.9% and 12.0% for patients with CD, and 12.7% and 0.9% for patients with UC, respectively. Perianal CD was associated with an increased risk of anti-TNF therapy within 1 year of its diagnosis (HR, 2.97; 95% CI, 1.09–8.09). The cumulative probabilities for surgery 1 year after diagnosis were 9.1% for patients with CD and 0.9% for patients with UC. Patients with CD and penetrating disease had a 7-fold increase for risk of surgery, compared to patients with inflammatory disease (HR, 7.67; 95% CI, 3.93–14.96). Overall mortality for patients with IBD was 0.7%. Conclusion: In a prospective population-based study, we found that the early course of disease in patients with IBD in Asia was comparable to that of the West. Patients with CD frequently progress to complicated disease and have accelerated use of immunosuppressants. Few patients with early-stage UC undergo surgery in Asia. Increasing our understanding of IBD progression in different populations can help optimize therapy and improve outcomes.
Environmental risk factors in inflammatory bowel disease: a population-based case-control study in Asia-Pacific
(British Medical Assosiation, 2015) Ng, S.C.; Tang, W.; Leong, R.W.; Chen, M.; Ko, Y.; Studd, C.; Niewiadomski, O.; Bell, S.; Kamm, M.A.; de Silva, H.J.; Kasturiratne, A.; Senanayake, Y.U.; Ooi, C.J.; Ling, K.L.; Ong, D.; Goh, K.L.; Hilmi, I.; Ouyang, Q.; Wang, Y.F.; Hu, P.; Zhu, Z.; Zeng, Z.; Wu, K.; Wang, X.; Xia, B.; Li, J.; Pisespongsa, P.; Manatsathit, S.; Aniwan, S.; Simadibrata, M.; Abdullah, M.; Tsang, S. W.; Wong, T.C.; Hui, A.J.; Chow, C.M.; Yu, H.H.; Li, M.F.; Ng, K.K.; Ching, J.; Wu, J.C.; Chan, F.K.; Sung, J.J.
OBJECTIVE: The rising incidence of inflammatory bowel disease in Asia supports the importance of environmental risk factors in disease aetiology. This prospective population-based case-control study in Asia-Pacific examined risk factors prior to patients developing IBD. DESIGN: 442 incident cases (186 Crohn's disease (CD); 256 UC; 374 Asians) diagnosed between 2011 and 2013 from eight countries in Asia and Australia and 940 controls (frequency-matched by sex, age and geographical location; 789 Asians) completed an environmental factor questionnaire at diagnosis. Unconditional logistic regression models were used to estimate adjusted ORs (aOR) and 95% CIs. RESULTS: In multivariate model, being breast fed >12 months (aOR 0.10; 95% CI 0.04 to 0.30), antibiotic use (aOR 0.19; 0.07 to 0.52), having dogs (aOR 0.54; 0.35 to 0.83), daily tea consumption (aOR 0.62; 0.43 to 0.91) and daily physical activity (aOR 0.58; 0.35 to 0.96) decreased the odds for CD in Asians. In UC, being breast fed >12 months (aOR 0.16; 0.08 to 0.31), antibiotic use (aOR 0.48; 0.27 to 0.87), daily tea (aOR 0.63; 0.46 to 0.86) or coffee consumption (aOR 0.51; 0.36 to 0.72), presence of hot water tap (aOR 0.65; 0.46 to 0.91) and flush toilet in childhood (aOR 0.71; 0.51 to 0.98) were protective for UC development whereas ex-smoking (aOR 2.02; 1.22 to 3.35) increased the risk of UC. CONCLUSIONS: This first population-based study of IBD risk factors in Asia-Pacific supports the importance of childhood immunological, hygiene and dietary factors in the development of IBD, suggesting that markers of altered intestinal microbiota may modulate risk of IBD later in life. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Incidence and phenotype of inflammatory bowel disease based on results from the Asia-pacific Crohn's and colitis epidemiology study
(Elsevier-W.B. Saunders, 2013) Ng, S.C.; Tang, W.; Ching, J.Y.; Wong, M.; Chow, C.M.; Hui, A.J.; Wong, T.C.; Leung, V.K.; Tsang, S.W.; Yu, H.H.; Li, M.F.; Ng, K.K.; Kamm, M.A.; Studd, C.; Bell, S.; Leong, R.; de Silva, H.J.; Kasturiratne, A.; Mufeena, M.N.; Ling, K.L.; Ooi, C.J.; Tan, P.S.; Ong, D.; Goh, K.L.; Hilmi, I.; Pisespongsa, P.; Manatsathit, S.; Rerknimitr, R.; Aniwan, S.; Wang, Y.F.; Ouyang, Q.; Zeng, Z.; Zhu, Z.; Chen, M.H.; Hu, P.J.; Wu, K.; Wang, X.; Simadibrata, M.; Abdullah, M.; Wu, J.C.; Sung, J.J.; Chan, F.K.; Asia-Pacific Crohn's and Colitis Epidemiologic Study (ACCESS) Study Group
BACKGROUND & AIMS: Inflammatory bowel diseases (IBD) are becoming more common in Asia, but epidemiologic data are lacking. The Asia Pacific Crohn's and Colitis Epidemiology Study aimed to determine the incidence and phenotype of IBD in 8 countries across Asia and in Australia. METHODS: We performed a prospective, population-based study of IBD incidence in predefined catchment areas, collecting data for 1 year, starting on April 1, 2011. New cases were ascertained from multiple overlapping sources and entered into a Web-based database. Cases were confirmed using standard criteria. Local endoscopy, pathology, and pharmacy records were searched to ensure completeness of case capture. RESULTS: We identified 419 new cases of IBD (232 of ulcerative colitis [UC], 166 of Crohn's disease [CD], and 21 IBD-undetermined). The crude annual overall incidence values per 100,000 individuals were 1.37 for IBD in Asia (95% confidence interval: 1.25-1.51; 0.76 for UC, 0.54 for CD, and 0.07 for IBD-undetermined) and 23.67 in Australia (95% confidence interval: 18.46-29.85; 7.33 for UC, 14.00 for CD, and 2.33 for IBD-undetermined). China had the highest incidence of IBD in Asia (3.44 per 100,000 individuals). The ratios of UC to CD were 2.0 in Asia and 0.5 in Australia. Median time from symptom onset to diagnosis was 5.5 months (interquartile range, 1.4-15 months). Complicated CD (stricturing, penetrating, or perianal disease) was more common in Asia than Australia (52% vs 24%; P = .001), and a family history of IBD was less common in Asia (3% vs 17%; P < .001). CONCLUSIONS: We performed a large-scale population-based study and found that although the incidence of IBD varies throughout Asia, it is still lower than in the West. IBD can be as severe or more severe in Asia than in the West. The emergence of IBD in Asia will result in the need for specific health care resources, and offers a unique opportunity to study etiologic factors in developing nations.
Population density and risk of inflammatory bowel disease: a prospective population-based study in 13 countries or regions in Asia-Pacific.
(Wolters Kluwer Health, 2019) Ng, S.C.; Kaplan, G.G.; Tang, W.; Banerjee, R.; Adigopula, B.; Underwood, F.E.; Tanyingoh, D.; Wei, S.C.; Lin, W.C.; Lin, H.H.; Li, J.; Bell, S.; Niewiadomski, O.; Kamm, M.A.; Zeng, Z.; Chen, M.; Hu, P.; Ong, D.; Ooi, C.J.; Ling, K. L.; Miao, Y.; Miao, J.; de Silva, H.J.; Niriella, M.A.; Aniwan, S.; Limsrivilai, J.; Pisespongsa, P.; Wu, K.; Yang, H.; Ng, K.K.; Yu, H. H.; Wang, Y.; Ouyang, Q.; Abdullah, M.; Simadibrata, M.; Gunawan, J.; Hilmi, I.; Goh, K. L.; Cao, Q.; Sheng, H.; Ong-Go, A.; Chong, V. H.; Ching, J. Y. L.; Wu, J. C. Y.; Chan, F.K.L.; Sung, J.J.Y.
INTRODUCTION: Living in an urban environment may increase the risk of developing inflammatory bowel disease (IBD). It is unclear if this observation is seen globally. We conducted a population-based study to assess the relationship between urbanization and incidence of IBD in the Asia-Pacific region. METHODS: Newly diagnosed IBD cases between 2011 and 2013 from 13 countries or regions in Asia-Pacific were included. Incidence was calculated with 95% confidence interval (CI) and pooled using random-effects model. Meta-regression analysis was used to assess incidence rates and their association with population density, latitude, and longitude. RESULTS: We identified 1175 ulcerative colitis (UC), 656 Crohn's disease (CD), and 37 IBD undetermined (IBD-U). Mean annual IBD incidence per 100 000 was 1.50 (95% CI: 1.43-1.57). India (9.31; 95% CI: 8.38-10.31) and China (3.64; 95% CI, 2.97-4.42) had the highest IBD incidence in Asia. Incidence of overall IBD (incidence rate ratio [IRR]: 2.19; 95% CI: 1.01-4.76]) and CD (IRR: 3.28; 95% CI: 1.83-9.12) was higher across 19 areas of Asia with a higher population density. In China, incidence of IBD (IRR: 2.37; 95% CI: 1.10-5.16) and UC (IRR: 2.63; 95% CI: 1.2-5.8) was positively associated with gross domestic product. A south-to-north disease gradient (IRR: 0.94; 95% CI: 0.91-0.98) was observed for IBD incidence and a west-to-east gradient (IRR: 1.14; 95% CI: 1.05-1.24) was observed for CD incidence in China. This study received IRB approval. CONCLUSIONS: Regions in Asia with a high population density had a higher CD and UC incidence. Coastal areas within China had higher IBD incidence. With increasing urbanization and a shift from rural areas to cities, disease incidence may continue to climb in Asia.
Quality of life of inflammatory bowel disease at diagnosis in 8 countries in Asia: The ACCESS study
(Wiley Blackwell Scientific Publications, 2013) Ng, S.C.; Tang, W.; de Silva, H.J.; Mettananda, K.C.D.; Weerasinghe, S.K.; Ling, K.L.; Ho, L.; Ong, D.; Ooi, C.J.; Hilmi, I.; Goh, K.L.; Manatsathit, S.; Aniwan, S.; Pisespongsa, P.; Abdullah, M.; Zeng, Z.; Hu, P.; Chen, M.; Ouyang, Q.; Wang, Y.F.; WU, K.; Ng, K.K.; Yu, H.H.; Ching, J.; Sung, J.; Chan, F.K.
OBJECTIVE: Health-related quality of life (QOL) is an important outcome measure in inflammatory bowel disease (IBD). QOL of Asian patients with IBD at presentation has not been studied. AIM: This study evaluates the QOL of IBD patients at diagnosis from an inception cohort across eight countries in Asia. METHODS: Health-related QOL was measured by the validated IBD Questionnaire (IBDQ) in patients with newly diagnosed IBD between 2011 and 2012. Disease activity was assessed by the Simple Clinical Colitis Activity Index and Harvey-Bradshaw index for ulcerative colitis (UC) and Crohn’s disease (CD), respectively. Demographic and disease characteristics were recorded. RESULTS: 284 incident IBD cases (CD 93; UC 147; IC 14) were included. Median age was 37 (IQR: 26–49). Median duration from symptom onset to diagnosis was 6 months (IQR:2– 24). Overall mean IBDQ score was 159 ± SEM 2.2 (Remission: IBQ≥170). The median IBDQ Score of South Asians (Thailand, Malaysia, Indonesia, Sri Lanka) (150; IQR:117–181) was significantly lower than the Han Chinese (Mainland China, Hong Kong, Singapore, Macau) (167; IQR:139–190; p = 0.003). IBD patients with active disease had significantly lower scores for all 4 dimensions of IBDQ (bowel, systemic, emotional and social functions) compared with those in remission (p < 0.001). Multiple regression analyses identified only disease activity index to be associated with variations in QOL (p < 0.001). There was no significant difference in QOL between patients with CD, UC or IC (p = 0.403). QOLwas not significantly affected by disease behavior for CD (B1, B2, B3, or perianal) but worsened with increasing mucosal involvement in UC (extensive > distal > proctitis; p = 0.014). QOL score was not affected by employment status, education level or smoking history. CONCLUSION: QOL is impaired in newly diagnosed IBD patients, and varies across ethnic groups in Asia. Active disease and more extensive disease are associated with worse QOL in IBD.