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

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DOI

  • Johan Burisch, Københavns Universitet
  • ,
  • Gediminas Kiudelis, Lithuanian University of Health Sciences
  • ,
  • Limas Kupcinskas, Lithuanian University of Health Sciences
  • ,
  • Hendrika Adriana Linda Kievit, Herning Cent Hosp, Aarhus University, Dept Med
  • ,
  • Karina Winther Andersen, Viborg Reg Hosp, Aarhus University, Med Dept
  • ,
  • Vibeke Andersen, IRS-Centre Sonderjylland, Hospital of Southern Jutland, Aabenraa, Denmark.
  • ,
  • Riina Salupere, Univ Tarty, University of Tartu, Tartu Univ Hosp, Div Gastroenterol
  • ,
  • Natalia Pedersen, Slagelse Hosp, Gastroenterol Dept
  • ,
  • Jens Kjeldsen, Syddansk Universitet
  • ,
  • Epi-IBD Grp

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

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.

OriginalsprogEngelsk
TidsskriftGut
Vol/bind68
Nummer3
Sider (fra-til)423-433
Antal sider11
ISSN0017-5749
DOI
StatusUdgivet - mar. 2019

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