Disease course of inflammatory bowel disease unclassified in a European population-based inception cohort: An Epi-IBD study

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  • Johan Burisch, North Zealand Univ Hosp, Dept Gastroenterol
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  • Stefania Chetcuti Zammit, Mater Dei Hosp, Div Gastroenterol
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  • Pierre Ellul, Mater Dei Hosp, Div Gastroenterol
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  • Svetlana Turcan, State Univ Med & Pharm Republ Moldova, Nicolae Testemitanu State University of Medicine & Pharmacy, Dept Gastroenterol
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  • Dana Duricova, Charles Univ Prague, Charles University Prague, IBD Clin & Res Ctr, ISCARE
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  • Martin Bortlik, Charles Univ Prague, Charles University Prague, Med Fac 1, Inst Pharmacol
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  • Karina Winther Andersen, Viborg Reg Hosp, Aarhus University, Med Dept
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  • Vibeke Andersen, IRS-Centre Sonderjylland, Hospital of Southern Jutland, Aabenraa, Denmark.
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  • Ioannis P. Kaimakliotis
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  • Mathurin Fumery, Amiens Univ Hosp, CHU Amiens, CHU Amiens Sud, Gastroenterol Unit, Epimad Registry
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  • Corinne Gower-Rousseau, Univ Lille, Fondation I-SITE ULNE, Universite de Lille, Lille Inflammat Res Int Ctr LIRIC
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  • Giulia Girardin, Univ Padua, University of Padua, Azienda, Dept Surg Oncol & Gastroenterol Sci
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  • Daniela Valpiani, Hosp Morgagni Pierantoni, UO Gastroenterol & Endoscopia Digest
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  • Adrian Goldis, Univ Med Victor Babes, Victor Babes University of Medicine & Pharmacy, Timisoara, Clin Gastroenterol
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  • Marko Brinar, Univ Hosp Ctr Zagreb, University of Zagreb, Div Gastroenterol & Hepatol
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  • Silvija Cukovic-Cavka, Univ Hosp Ctr Zagreb, University of Zagreb, Div Gastroenterol & Hepatol
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  • Pia Oksanen, Tampere Univ Hosp, University of Tampere
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  • Pekka Collin, Tampere Univ Hosp, University of Tampere
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  • Luisa Barros, Ctr Hosp Sao Joao EPE, Dept Gastroenterol
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  • Fernando Magro, Univ Porto, Universidade do Porto, Fac Med, Inst Pharmacol, Dept Biomed
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  • Ravi Misra, Imperial Coll London, Imperial College London, St Marks Hosp, IBD Dept
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  • Naila Arebi, Imperial Coll London, Imperial College London, St Marks Hosp, IBD Dept
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  • Carl Eriksson, Orebro Univ, Orebro University, Fac Med & Hlth, Dept Gastroenterol
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  • Jonas Halfvarson, Orebro Univ, Orebro University, Fac Med & Hlth, Dept Gastroenterol
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  • Hendrika Adriana Linda Kievit, Herning Cent Hosp, Aarhus University, Dept Med
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  • Natalia Pedersen, Slagelse Hosp, Gastroenterol Dept
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  • Jens Kjeldsen, Odense Univ Hosp, University of Southern Denmark, Odense University Hospital, Dept Gastroenterol
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  • Sally Myers, Hull & East Yorkshire NHS Trust, IBD Unit
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  • Shaji Sebastian, Hull & East Yorkshire NHS Trust, IBD Unit
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  • Konstantinos H. Katsanos, Univ Hosp Ioannina, University Hospital Ioannina, Dept Gastroenterol
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  • Dimitrios K. Christodoulou, Univ Hosp Ioannina, University Hospital Ioannina, Dept Gastroenterol
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  • Jongerd Midjord, Natl Hosp Faroe Islands, Med Dept
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  • Kari Rubek Nielsen, Univ Hosp Ioannina, University Hospital Ioannina, Dept Gastroenterol
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  • Gediminas Kiudelis, Lithuanian Univ Hlth Sci, Lithuanian University of Health Sciences, Med Acad, Inst Digest Res
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  • Limas Kupcinskas, Lithuanian Univ Hlth Sci, Lithuanian University of Health Sciences, Med Acad, Dept Gastroenterol
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  • Inna Nikulina, Moscow Reg Res Clin Inst, Dept Gastroenterol
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  • Elena Belousova, Moscow Reg Res Clin Inst, Dept Gastroenterol
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  • Doron Schwartz, Ben Gurion Univ Negev, Ben Gurion University, Dept Life Sci
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  • Selwyn Odes, Ben Gurion Univ Negev, Ben Gurion University, Dept Life Sci
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  • Riina Salupere, Univ Tarty, University of Tartu, Tartu Univ Hosp, Div Gastroenterol
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  • Amalia Carmona, POVISA Hosp, Dept Gastroenterol
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  • Juan R. Pineda, Hosp Alvaro Cunqueiro, Inst Invest Sanitaria Galicia Sur, EOXI Vigo, Dept Gastroenterol
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  • Zsuzsanna Vegh, Semmelweis Univ, Semmelweis University, Dept Family Med, Fac Med
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  • Peter L. Lakatos, McGill Univ, McGill University, Div Gastroenterol, Ctr Hlth, Semmelweis University
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  • Ebbe Langholz, Københavns Universitet
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  • Pia Munkholm, North Zealand University Hospital
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  • Epi-IBD Grp

Background and Aim A definitive diagnosis of Crohn's disease (CD) or ulcerative colitis (UC) is not always possible, and a proportion of patients will be diagnosed as inflammatory bowel disease unclassified (IBDU). The aim of the study was to investigate the prognosis of patients initially diagnosed with IBDU and the disease course during the following 5 years. Methods The Epi-IBD study is a prospective population-based cohort of 1289 IBD patients diagnosed in centers across Europe. Clinical data were captured prospectively throughout the follow-up period. Results Overall, 476 (37%) patients were initially diagnosed with CD, 701 (54%) with UC, and 112 (9%) with IBDU. During follow-up, 28 (25%) IBDU patients were changed diagnoses to either UC (n = 20, 71%) or CD (n = 8, 29%) after a median of 6 months (interquartile range: 4-12), while 84 (7% of the total cohort) remained IBDU. A total of 17 (15%) IBDU patients were hospitalized for their IBD during follow-up, while 8 (7%) patients underwent surgery. Most surgeries (n = 6, 75%) were performed on patients whose diagnosis was later changed to UC; three of these colectomies led to a definitive diagnosis of UC. Most patients (n = 107, 96%) received 5-aminosalicylic acid, while 11 (10%) patients received biologicals, of whom five remained classified as IBDU. Conclusions In a population-based inception cohort, 7% of IBD patients were not given a definitive diagnosis of IBD after 5 years of follow-up. One in four patients with IBDU eventually was classified as CD or UC. Overall, the disease course and medication burden in IBDU patients were mild.

OriginalsprogEngelsk
TidsskriftJournal of Gastroenterology and Hepatology
Vol/bind34
Nummer6
Sider (fra-til)996-1003
Antal sider8
ISSN0815-9319
DOI
StatusUdgivet - jun. 2019

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