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  • Burisch, JDepartment of Gastroenterology, Nordsjællands Hospital, University of Copenhagen, Frederikssund, Denmark (author)

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

  • Article/chapterEnglish2019

Publisher, publication year, extent ...

  • 2018-01-23
  • BMJ,2019

Numbers

  • LIBRIS-ID:oai:prod.swepub.kib.ki.se:141202547
  • http://kipublications.ki.se/Default.aspx?queryparsed=id:141202547URI
  • https://doi.org/10.1136/gutjnl-2017-315568DOI
  • https://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-64714URI

Supplementary language notes

  • Language:English
  • Summary in:English

Part of subdatabase

Classification

  • Subject category:ref swepub-contenttype
  • Subject category:art swepub-publicationtype

Notes

  • Funding Agencies:Kirsten og Freddy Johansens Fond  Nordsjaellands Hospital Forskningsrad
  • 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).DesignPatients 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.ResultsIn 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).ConclusionDespite 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.

Subject headings and genre

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  • Kiudelis, GInstitute for Digestive Research, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania (author)
  • Kupcinskas, LInstitute for Digestive Research, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania; Department of Gastroenterology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania (author)
  • Kievit, HALDepartment of Medicine, Herning Central Hospital, Herning, Denmark (author)
  • Andersen, KWMedical Department, Regional Hospital of Viborg, Viborg, Denmark (author)
  • Andersen, VMedical Department, Regional Hospital of Viborg, Viborg, Denmark; Focused research unit for Molecular Diagnostic and Clinical Research (MOK), IRS-Center Sonderjylland, Hospital of Southern Jutland, Aabenraa, Denmark (author)
  • Salupere, RDivision of Gastroenterology, Tartu University Hospital, University of Tartyu, Tartu, Estonia (author)
  • Pedersen, NGastroenterology Department, Slagelse Hospital, Slagelse, Denmark (author)
  • Kjeldsen, JGastroenterology Department, Odense University Hospital, Odense, Denmark (author)
  • D'Inca, RDepartment of Surgical, Oncological and Gastroenterological Sciences, Azienda, University of Padua, Padova, Italy,IBD Clinical and Research Centre (ISCARE), Prague, Czech Republic (author)
  • Valpiani, DU.O. Gastroenterologia ed Endoscopia digestiva, Hospital Morgagni Pierantoni, Forlì, Italy (author)
  • Schwartz, DDepartment of Gastroenterology and Hepatology, Soroka Medical Center, Ben Gurion University of the Negev, Beer Sheva, Israel (author)
  • Odes, SDepartment of Gastroenterology and Hepatology, Soroka Medical Center, Ben Gurion University of the Negev, Beer Sheva, Israel (author)
  • Olsen, JMedical Department, The National Hospital of the Faroe Islands, Thorshavn, Denmark (author)
  • Nielsen, KRMedical Department, The National Hospital of the Faroe Islands, Thorshavn, Denmark (author)
  • Vegh, Z1st Department of Medicine, Semmelweis University, Budapest, Hungary (author)
  • Lakatos, PL1st Department of Medicine, Semmelweis University, Budapest, Hungary; Division of Gastroenterology, McGill University Health Center, Montreal, Canada (author)
  • Toca, ADepartment of Gastroenterology, State University of Medicine and Pharmacy of the Republic of Moldova, Chisinau, Republic of Moldova (author)
  • Turcan, SDepartment of Gastroenterology, State University of Medicine and Pharmacy of the Republic of Moldova, Chisinau, Republic of Moldova (author)
  • Katsanos, KHDepartment of Gastroenterology, University Hospital of Ioannina, Ioannina, Greece (author)
  • Christodoulou, DKDepartment of Gastroenterology, University Hospital of Ioannina, Ioannina, Greece (author)
  • Fumery, MGastroenterology Unit, Epimad Registry, Centre hospitalier universitaire (CHU) Amiens Sud, Amiens University Hospital, Amiens, France (author)
  • Gower-Rousseau, CPublic Health, Epidemiology and Economic Health, Registre Epimad, Lille Hospital, Lille University, Lille, France; Lille Inflammation Research International Center (LIRIC), Lille University, Lille, France (author)
  • Zammit, SCDivision of Gastroenterology, Mater Dei Hospital, Msida, Malta,IBD Unit, Hull and East Yorkshire NHS Trust, Hull, UK (author)
  • Ellul, PDivision of Gastroenterology, Mater Dei Hospital, Msida, Malta (author)
  • Eriksson, Carl,1981-Örebro universitet,Institutionen för medicinska vetenskaper,Department of Gastroenterology, Faculty of Health and Medical Sciences, Örebro University, Örebro, Sweden(Swepub:oru)clen (author)
  • Halfvarson, Jonas,1970-Örebro universitet,Institutionen för medicinska vetenskaper,Department of Gastroenterology, Faculty of Health and Medical Sciences, Örebro University, Örebro, Sweden(Swepub:oru)jshn (author)
  • Magro, FJDepartment of Gastroenterology, Centro Hospitalar de São João EPE, Porto, Portugal; Department of Biomedicine, Institute of Pharmacology, Faculty of Medicine, Porto University, Porto, Portugal (author)
  • Duricova, D (author)
  • Bortlik, MIBD Clinical and Research Centre (ISCARE), Prague, Czech Republic; Institute of Pharmacology, 1st Faculty of Medicine, Charles University in Prague, Prague, Czech Republic (author)
  • Fernandez, ADepartment of Gastroenterology, Hospital POVISA, Vigo, Spain (author)
  • Hernandez, VDepartment of Gastroenterology, Hospital Alvaro Cunqueiro. Instituto Investigación Sanitaria Galicia Sur. EOXI de Vigo, Vigo, Spain (author)
  • Myers, SIBD Unit, Hull and East Yorkshire NHS Trust, Hull, UK (author)
  • Sebastian, S (author)
  • Oksanen, PDepartment of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Tampere, Finland; University of Tampere, Tampere, Finland (author)
  • Collin, PUniversity of Tampere, Tampere, Finland (author)
  • Goldis, AClinic of Gastroenterology, University of Medicine 'Victor Babes', Timisoara, Romania (author)
  • Misra, RIBD Department, Imperial College London, London, UK (author)
  • Arebi, NIBD Department, Imperial College London, London, UK (author)
  • Kaimakliotis, IPNicosia private practice, Nicosia, Cyprus (author)
  • Nikuina, IDepartment of Gastroenterology, Moscow Regional Research Clinical Institute, Moscow, Russian Federation (author)
  • Belousova, EDepartment of Gastroenterology, Moscow Regional Research Clinical Institute, Moscow, Russian Federation (author)
  • Brinar, MDivision of Gastroenterology and Hepatology, University Hospital Center Zagreb, Zagreb, Croatia (author)
  • Cukovic-Cavka, SDivision of Gastroenterology and Hepatology, University Hospital Center Zagreb, Zagreb, Croatia (author)
  • Langholz, EDepartment of Gastroenterology, Herlev and Gentofte Hospital, University of Copenhagen, Herlev, Denmark (author)
  • Munkholm, PDepartment of Gastroenterology, Nordsjællands Hospital, University of Copenhagen, Frederikssund, Denmark (author)
  • Niewiadomski, O (author)
  • Bell, S (author)
  • Turk, N (author)
  • Cukovic-Cavka, S (author)
  • Kaimakliotis, I (author)
  • Nicolaou, A (author)
  • Duricova, D (author)
  • Lukas, M (author)
  • Bortlik, M (author)
  • Shonova, O (author)
  • Burisch, J (author)
  • Munkholm, P (author)
  • Langholz, E (author)
  • Blichfeldt, B (author)
  • Marker, D (author)
  • Carlsen, K (author)
  • Weimers, P (author)
  • Pedersen, N (author)
  • Kjeldsen, J (author)
  • Aalykke, C (author)
  • Dahlerup, JF (author)
  • Kudsk, K (author)
  • Andersen, V (author)
  • Vind, I (author)
  • Thorsgaard, N (author)
  • Salupere, R (author)
  • Olsen, J (author)
  • Nielsen, KR (author)
  • Oksanen, P (author)
  • Collin, P (author)
  • Katsanos, KH (author)
  • Christodoulou, DK (author)
  • Skamnelos, A (author)
  • Politis, D (author)
  • Ladefoged, K (author)
  • Lakatos, PL (author)
  • Vegh, Z (author)
  • Lakatos, L (author)
  • Demenyi, P (author)
  • Kramli, SN (author)
  • O'Morain, C (author)
  • Dal Piaz, G (author)
  • Santini, A (author)
  • Girardin, G (author)
  • D'Inca, R (author)
  • Schwartz, D (author)
  • Odes, S (author)
  • Kupcinskas, L (author)
  • Jonaitis, L (author)
  • Kiudelis, G (author)
  • Valantiene, I (author)
  • Department of Gastroenterology, Nordsjællands Hospital, University of Copenhagen, Frederikssund, DenmarkInstitute for Digestive Research, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania (creator_code:org_t)

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  • In:Gut: BMJ68:3, s. 423-4331468-32880017-5749

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