RT Journal Article
SR Electronic
T1 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
JF Gut
JO Gut
FD BMJ Publishing Group Ltd and British Society of Gastroenterology
SP 423
OP 433
DO 10.1136/gutjnl-2017-315568
VO 68
IS 3
A1 Johan Burisch
A1 Gediminas Kiudelis
A1 Limas Kupcinskas
A1 Hendrika Adriana Linda Kievit
A1 Karina Winther Andersen
A1 Vibeke Andersen
A1 Riina Salupere
A1 Natalia Pedersen
A1 Jens Kjeldsen
A1 Renata D’Incà
A1 Daniela Valpiani
A1 Doron Schwartz
A1 Selwyn Odes
A1 Jóngerð Olsen
A1 Kári Rubek Nielsen
A1 Zsuzsanna Vegh
A1 Peter Laszlo Lakatos
A1 Alina Toca
A1 Svetlana Turcan
A1 Konstantinos H Katsanos
A1 Dimitrios K Christodoulou
A1 Mathurin Fumery
A1 Corinne Gower-Rousseau
A1 Stefania Chetcuti Zammit
A1 Pierre Ellul
A1 Carl Eriksson
A1 Jonas Halfvarson
A1 Fernando Jose Magro
A1 Dana Duricova
A1 Martin Bortlik
A1 Alberto Fernandez
A1 Vicent Hernández
A1 Sally Myers
A1 Shaji Sebastian
A1 Pia Oksanen
A1 Pekka Collin
A1 Adrian Goldis
A1 Ravi Misra
A1 Naila Arebi
A1 Ioannis P Kaimakliotis
A1 Inna Nikuina
A1 Elena Belousova
A1 Marko Brinar
A1 Silvija Cukovic-Cavka
A1 Ebbe Langholz
A1 Pia Munkholm
A1 ,
YR 2019
UL http://gut.bmj.com/content/68/3/423.abstract
AB 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.