Temporal trends in characteristics and management of inflammatory bowel disease

Jessica C. Young; Lise M. Helsingen; Erle Refsum; Amanda Högdén; Vera Perrin; Magnus Løberg; Rasmus H. Gantzel; Michael Bretthauer; Anita Berglund; Øyvind Holme; Henriette Cecilie Jodal; Tore Grimstad; Stephan A. Brackmann; Weimin Ye; Hans Olov Adami; Lone Larsen; Miguel A. Hernan; Tine Jess; Johannes Blom; Mette Kalager

doi:10.1080/00365521.2025.2478166

Temporal trends in characteristics and management of inflammatory bowel disease

Jessica C. Young^*, Lise M. Helsingen, Erle Refsum, Amanda Högdén, Vera Perrin, Magnus Løberg, Rasmus H. Gantzel, Michael Bretthauer, Anita Berglund, Øyvind Holme, Henriette Cecilie Jodal, Tore Grimstad, Stephan A. Brackmann, Weimin Ye, Hans Olov Adami, Lone Larsen, Miguel A. Hernan, Tine Jess, Johannes Blom, Mette Kalager

^*Corresponding author af dette arbejde

Institut for Klinisk Medicin - Lever-, Mave- og Tarmsygdomme

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avis › Review › Forskning › peer review

Abstract

Background and aims: Inflammatory bowel disease (IBD) requires complex clinical management. Despite substantial advancements in endoscopy and in pharmacotherapies for patients with IBD, it remains unclear how these developments have influenced IBD incidence and clinical care. We aim to describe changes in diagnostic and therapeutic practices in IBD management. Methods: All individuals diagnosed with IBD between 1987 and 2016 were identified from nationwide registries in Norway and Sweden. We performed detailed chart abstractions for a random sample of the cohort. We describe patient characteristics, disease extent, endoscopic practices, pathology diagnostics, pharmacological therapy and surgical management, stratifying by Crohn’s disease (CD) and ulcerative colitis [UC], comparing patients diagnosed before (pre-biologic period, 1987–1999), and after the introduction of biologic drugs (biologic period, 2000–2016). Results: Chart abstraction was completed for 791 individuals (UC: 58.8%, Crohn’s disease: 40.2%, unclassified IBD: 1.0%). Comparing the biologic period to the pre-biologic period, we observed an increase in endoscopies after diagnosis, more frequent colonoscopies, and a decrease in colon resection rates. Among those diagnosed in 2007 or later compared with those diagnosed between 2000 and 2006, there was a higher treatment initiation rate of azathioprine, infliximab and adalimumab within 1 year after diagnosis. Conclusions: Our findings suggest a shift towards more frequent endoscopy, increased use of immunosuppressants and biologics, and decreased colon resection rates in recent periods.

Originalsprog	Engelsk
Tidsskrift	Scandinavian Journal of Gastroenterology
Vol/bind	60
Nummer	5
Sider (fra-til)	421-429
Antal sider	9
ISSN	0036-5521
DOI	https://doi.org/10.1080/00365521.2025.2478166
Status	Udgivet - 2025

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10.1080/00365521.2025.2478166Licens: CC BY

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Young, J. C., Helsingen, L. M., Refsum, E., Högdén, A., Perrin, V., Løberg, M., Gantzel, R. H., Bretthauer, M., Berglund, A., Holme, Ø., Jodal, H. C., Grimstad, T., Brackmann, S. A., Ye, W., Adami, H. O., Larsen, L., Hernan, M. A., Jess, T., Blom, J., & Kalager, M. (2025). Temporal trends in characteristics and management of inflammatory bowel disease. Scandinavian Journal of Gastroenterology, 60(5), 421-429. https://doi.org/10.1080/00365521.2025.2478166

@article{cee872a7e7814f5f83058cd743b9a891,

title = "Temporal trends in characteristics and management of inflammatory bowel disease",

abstract = "Background and aims: Inflammatory bowel disease (IBD) requires complex clinical management. Despite substantial advancements in endoscopy and in pharmacotherapies for patients with IBD, it remains unclear how these developments have influenced IBD incidence and clinical care. We aim to describe changes in diagnostic and therapeutic practices in IBD management. Methods: All individuals diagnosed with IBD between 1987 and 2016 were identified from nationwide registries in Norway and Sweden. We performed detailed chart abstractions for a random sample of the cohort. We describe patient characteristics, disease extent, endoscopic practices, pathology diagnostics, pharmacological therapy and surgical management, stratifying by Crohn{\textquoteright}s disease (CD) and ulcerative colitis [UC], comparing patients diagnosed before (pre-biologic period, 1987–1999), and after the introduction of biologic drugs (biologic period, 2000–2016). Results: Chart abstraction was completed for 791 individuals (UC: 58.8%, Crohn{\textquoteright}s disease: 40.2%, unclassified IBD: 1.0%). Comparing the biologic period to the pre-biologic period, we observed an increase in endoscopies after diagnosis, more frequent colonoscopies, and a decrease in colon resection rates. Among those diagnosed in 2007 or later compared with those diagnosed between 2000 and 2006, there was a higher treatment initiation rate of azathioprine, infliximab and adalimumab within 1 year after diagnosis. Conclusions: Our findings suggest a shift towards more frequent endoscopy, increased use of immunosuppressants and biologics, and decreased colon resection rates in recent periods.",

keywords = "immunomodulators, Inflammatory bowel disease, surveillance",

author = "Young, {Jessica C.} and Helsingen, {Lise M.} and Erle Refsum and Amanda H{\"o}gd{\'e}n and Vera Perrin and Magnus L{\o}berg and Gantzel, {Rasmus H.} and Michael Bretthauer and Anita Berglund and {\O}yvind Holme and Jodal, {Henriette Cecilie} and Tore Grimstad and Brackmann, {Stephan A.} and Weimin Ye and Adami, {Hans Olov} and Lone Larsen and Hernan, {Miguel A.} and Tine Jess and Johannes Blom and Mette Kalager",

year = "2025",

doi = "10.1080/00365521.2025.2478166",

language = "English",

volume = "60",

pages = "421--429",

journal = "Scandinavian Journal of Gastroenterology",

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Young, JC, Helsingen, LM, Refsum, E, Högdén, A, Perrin, V, Løberg, M, Gantzel, RH, Bretthauer, M, Berglund, A, Holme, Ø, Jodal, HC, Grimstad, T, Brackmann, SA, Ye, W, Adami, HO, Larsen, L, Hernan, MA, Jess, T, Blom, J & Kalager, M 2025, 'Temporal trends in characteristics and management of inflammatory bowel disease', Scandinavian Journal of Gastroenterology, bind 60, nr. 5, s. 421-429. https://doi.org/10.1080/00365521.2025.2478166

TY - JOUR

T1 - Temporal trends in characteristics and management of inflammatory bowel disease

AU - Young, Jessica C.

AU - Helsingen, Lise M.

AU - Refsum, Erle

AU - Högdén, Amanda

AU - Perrin, Vera

AU - Løberg, Magnus

AU - Gantzel, Rasmus H.

AU - Bretthauer, Michael

AU - Berglund, Anita

AU - Holme, Øyvind

AU - Jodal, Henriette Cecilie

AU - Grimstad, Tore

AU - Brackmann, Stephan A.

AU - Ye, Weimin

AU - Adami, Hans Olov

AU - Larsen, Lone

AU - Hernan, Miguel A.

AU - Jess, Tine

AU - Blom, Johannes

AU - Kalager, Mette

PY - 2025

Y1 - 2025

N2 - Background and aims: Inflammatory bowel disease (IBD) requires complex clinical management. Despite substantial advancements in endoscopy and in pharmacotherapies for patients with IBD, it remains unclear how these developments have influenced IBD incidence and clinical care. We aim to describe changes in diagnostic and therapeutic practices in IBD management. Methods: All individuals diagnosed with IBD between 1987 and 2016 were identified from nationwide registries in Norway and Sweden. We performed detailed chart abstractions for a random sample of the cohort. We describe patient characteristics, disease extent, endoscopic practices, pathology diagnostics, pharmacological therapy and surgical management, stratifying by Crohn’s disease (CD) and ulcerative colitis [UC], comparing patients diagnosed before (pre-biologic period, 1987–1999), and after the introduction of biologic drugs (biologic period, 2000–2016). Results: Chart abstraction was completed for 791 individuals (UC: 58.8%, Crohn’s disease: 40.2%, unclassified IBD: 1.0%). Comparing the biologic period to the pre-biologic period, we observed an increase in endoscopies after diagnosis, more frequent colonoscopies, and a decrease in colon resection rates. Among those diagnosed in 2007 or later compared with those diagnosed between 2000 and 2006, there was a higher treatment initiation rate of azathioprine, infliximab and adalimumab within 1 year after diagnosis. Conclusions: Our findings suggest a shift towards more frequent endoscopy, increased use of immunosuppressants and biologics, and decreased colon resection rates in recent periods.

AB - Background and aims: Inflammatory bowel disease (IBD) requires complex clinical management. Despite substantial advancements in endoscopy and in pharmacotherapies for patients with IBD, it remains unclear how these developments have influenced IBD incidence and clinical care. We aim to describe changes in diagnostic and therapeutic practices in IBD management. Methods: All individuals diagnosed with IBD between 1987 and 2016 were identified from nationwide registries in Norway and Sweden. We performed detailed chart abstractions for a random sample of the cohort. We describe patient characteristics, disease extent, endoscopic practices, pathology diagnostics, pharmacological therapy and surgical management, stratifying by Crohn’s disease (CD) and ulcerative colitis [UC], comparing patients diagnosed before (pre-biologic period, 1987–1999), and after the introduction of biologic drugs (biologic period, 2000–2016). Results: Chart abstraction was completed for 791 individuals (UC: 58.8%, Crohn’s disease: 40.2%, unclassified IBD: 1.0%). Comparing the biologic period to the pre-biologic period, we observed an increase in endoscopies after diagnosis, more frequent colonoscopies, and a decrease in colon resection rates. Among those diagnosed in 2007 or later compared with those diagnosed between 2000 and 2006, there was a higher treatment initiation rate of azathioprine, infliximab and adalimumab within 1 year after diagnosis. Conclusions: Our findings suggest a shift towards more frequent endoscopy, increased use of immunosuppressants and biologics, and decreased colon resection rates in recent periods.

KW - immunomodulators

KW - Inflammatory bowel disease

KW - surveillance

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U2 - 10.1080/00365521.2025.2478166

DO - 10.1080/00365521.2025.2478166

M3 - Review

C2 - 40126153

AN - SCOPUS:105000987702

SN - 0036-5521

VL - 60

SP - 421

EP - 429

JO - Scandinavian Journal of Gastroenterology

JF - Scandinavian Journal of Gastroenterology

IS - 5

ER -

Temporal trends in characteristics and management of inflammatory bowel disease

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