Natural disease course of Crohn's disease during the first 5 years after diagnosis in a European population-based inception cohort: an Epi-IBD study. Issue 3 (23rd January 2018)

• Record Type: Journal Article
• Authors: Burisch, Johan; Kiudelis, Gediminas; Kupcinskas, Limas; Kievit, Hendrika Adriana Linda; Andersen, Karina Winther; Andersen, Vibeke; Salupere, Riina; Pedersen, Natalia; Kjeldsen, Jens; D'Incà, Renata; Valpiani, Daniela; Schwartz, Doron; Odes, Selwyn; Olsen, Jóngerð; Nielsen, Kári Rubek; Vegh, Zsuzsanna; Lakatos, Peter Laszlo; Toca, Alina; Turcan, Svetlana; Katsanos, Konstantinos H; Christodoulou, Dimitrios K; Fumery, Mathurin; Gower-Rousseau, Corinne; Zammit, Stefania Chetcuti; Ellul, Pierre; Eriksson, Carl; Halfvarson, Jonas; Magro, Fernando Jose; Duricova, Dana; Bortlik, Martin; Fernandez, Alberto; Hernández, Vicent; Myers, Sally; Sebastian, Shaji; Oksanen, Pia; Collin, Pekka; Goldis, Adrian; Misra, Ravi; Arebi, Naila; Kaimakliotis, Ioannis P; Nikuina, Inna; Belousova, Elena; Brinar, Marko; Cukovic-Cavka, Silvija; Langholz, Ebbe; Munkholm, Pia;
• Other Names: author non-byline.; Niewiadomski Ola author non-byline.; Bell Sally author non-byline.; Turk Niksa author non-byline.; Cukovic-Cavka Silvija author non-byline.; Kaimakliotis Ioannis author non-byline.; Nicolaou Anastasia author non-byline.; Duricova Dana author non-byline.; Lukas Milan author non-byline.; Bortlík Martin author non-byline.; Shonová Olga author non-byline.; Burisch Johan author non-byline.; Munkholm Pia author non-byline.; Langholz Ebbe author non-byline.; Blichfeldt Birgitte author non-byline.; Marker Dorte author non-byline.; Carlsen Katrine author non-byline.; Weimers Petra author non-byline.; Pedersen Natalia author non-byline.; Kjeldsen Jens author non-byline.; Aalykke Clays author non-byline.; Dahlerup Jens Frederik author non-byline.; Kudsk Karen author non-byline.; Andersen Vibeke author non-byline.; Vind Ida author non-byline.; Thorsgaard Niels author non-byline.; Salupere Riina author non-byline.; Olsen Jóngerð author non-byline.; Nielsen Kári Rubek author non-byline.; Oksanen Pia author non-byline.; Collin Pekka author non-byline.; Katsanos Konstantinnos H author non-byline.; Christodoulou Dimitrios K author non-byline.; Skamnelos Alexandros author non-byline.; Politis Dimitrios author non-byline.; Ladefoged Karin author non-byline.; Lakatos Peter Laszlo author non-byline.; Vegh Zsuzsanna author non-byline.; Lakatos Laszlo author non-byline.; Demenyi Peterne author non-byline.; Kramli Szabina Nemethne author non-byline.; O'morain Colm author non-byline.; Piaz Giualia Dal author non-byline.; Santini Alessia author non-byline.; Girardin Giulia author non-byline.; D'inca Renata author non-byline.; Schwartz Doron author non-byline.; Odes Selwyn author non-byline.; Kupcinskas Limas author non-byline.; Jonaitis Laimas author non-byline.; Kiudelis Gediminas author non-byline.; Valantiene Irena author non-byline.; Zykus Romanas author non-byline.; Kucinskiene Ruta author non-byline.; Turcan Svetlana author non-byline.; Barros Louisa author non-byline.; Magro Fernando author non-byline.; Lazar Daniela author non-byline.; Goldis Adrian author non-byline.; Nikulina Inna author non-byline.; Belousova Elena author non-byline.; Hernandez Vicent author non-byline.; Castro Luisa De author non-byline.; Pineda Juan-ramon author non-byline.; Pereira Santos author non-byline.; Martinez-cadilla Jesus author non-byline.; Sanroman Luciano author non-byline.; Figueira Montserrat author non-byline.; Ares David Martinez author non-byline.; Rodriguez-prada Jose-ignacio author non-byline.; Fernandez Alberto author non-byline.; Carmona Amalia author non-byline.; Gonzalez-portela Carlos author non-byline.; Almer Sven author non-byline.; Granberg Lotta author non-byline.; Almer Benoît author non-byline.; Halfvarson Jonas author non-byline.; Widen Ulla-britt author non-byline.; Sebastian Shaji author non-byline.; Myers Sally author non-byline.; Ashton Katherine author non-byline.; Whitehead Emma author non-byline.; Arebi Naila author non-byline.;
• Is Part Of: Gut. Volume 68:Issue 3(2019)
• Page Start: 423
• Page End: 433
• Publication Date: 2018-01-23
• Subjects: crohn's disease -- surgery for Ibd -- epidemiology; Gastroenterology -- Periodicals; 616.33
• DOI: 10.1136/gutjnl-2017-315568
• Languages: English
• ISSNs: 0017-5749

Abstract

Abstract : Objective: The Epi-IBD cohort is a prospective population-based inception cohort of unselected patients with inflammatory bowel disease from 29 European centres covering a background population of almost 10 million people. The aim of this study was to assess the 5-year outcome and disease course of patients with Crohn's disease (CD). Design: Patients were followed up prospectively from the time of diagnosis, including collection of their clinical data, demographics, disease activity, medical therapy, surgery, cancers and deaths. Associations between outcomes and multiple covariates were analysed by Cox regression analysis. Results: In total, 488 patients were included in the study. During follow-up, 107 (22%) patients received surgery, while 176 (36%) patients were hospitalised because of CD. A total of 49 (14%) patients diagnosed with non-stricturing, non-penetrating disease progressed to either stricturing and/or penetrating disease. These rates did not differ between patients from Western and Eastern Europe. However, significant geographic differences were noted regarding treatment: more patients in Western Europe received biological therapy (33%) and immunomodulators (66%) than did those in Eastern Europe (14% and 54%, respectively, P<0.01), while more Eastern European patients received 5-aminosalicylates (90% vs 56%, P<0.05). Treatment with immunomodulators reduced the risk of surgery (HR: 0.4, 95% CI 0.2 to 0.6) and hospitalisation (HR: 0.3, 95% CI 0.2 to 0.5). Conclusion: Despite patients being treated early and frequently with immunomodulators and biological therapy in Western Europe, 5-year outcomes including surgery and phenotype progression in this cohort were comparable across Western and Eastern Europe. Differences in treatment strategies between Western and Eastern European centres did not affect the disease course. Treatment with immunomodulators reduced the risk of surgery and hospitalisation.