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Disease course of inflammatory bowel disease unclassified in a European population-based inception cohort: An Epi-IBD study
J. Burisch, SC. Zammit, P. Ellul, S. Turcan, D. Duricova, M. Bortlik, KW. Andersen, V. Andersen, IP. Kaimakliotis, M. Fumery, C. Gower-Rousseau, G. Girardin, D. Valpiani, A. Goldis, M. Brinar, S. Čuković-Čavka, P. Oksanen, P. Collin, L. Barros,...
Language English Country Australia
Document type Journal Article
Grant support
Nordsjaellands Hospital Forskningsråd
Kirsten og Freddy Johansens Fond
PubMed
30562421
DOI
10.1111/jgh.14563
Knihovny.cz E-resources
- MeSH
- Time Factors MeSH
- Adult MeSH
- Inflammatory Bowel Diseases diagnosis drug therapy epidemiology surgery MeSH
- Cohort Studies MeSH
- Colectomy MeSH
- Middle Aged MeSH
- Humans MeSH
- Mesalamine therapeutic use MeSH
- Follow-Up Studies MeSH
- Prognosis MeSH
- Disease Progression MeSH
- Prospective Studies MeSH
- Colitis, Ulcerative diagnosis drug therapy epidemiology surgery MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Geographicals
- Europe MeSH
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.
1st Department of Medicine Semmelweis University Budapest Hungary
Clinic of Gastroenterology University of Medicine 'Victor Babes' Timisoara Romania
Department of Gastroenterology Centro Hospitalar de São João EPE Porto Portugal
Department of Gastroenterology Faculty of Medicine and Health Örebro University Örebro Sweden
Department of Gastroenterology Hospital POVISA Vigo Spain
Department of Gastroenterology Moscow Regional Research Clinical Institute Moscow Russian Federation
Department of Gastroenterology North Zealand Hospital University of Copenhagen Copenhagen Denmark
Department of Gastroenterology University Hospital of Ioannina Ioannina Greece
Department of Medicine Herning Central Hospital Herning Denmark
Division of Gastroenterology and Hepatology University Hospital Center Zagreb Zagreb Croatia
Division of Gastroenterology Mater Dei Hospital Msida Malta
Division of Gastroenterology Tartu University Hospital University of Tarty Tartu Estonia
Gastroenterology Department Odense University Hospital Odense Denmark
Gastroenterology Department Slagelse Hospital Slagelse Denmark
IBD Clinical and Research Centre ISCARE Prague Czech Republic
IBD Department St Marks Hospital Imperial College London London UK
IBD Unit Hull and East Yorkshire NHS Trust Hull UK
Medical Department Regional Hospital of Viborg Viborg Denmark
Medical Department The National Hospital of the Faroe Islands Torshavn Faroe Islands
Nicosia Private Practice Nicosia Cyprus
U O Gastroenterologia ed Endoscopia digestiva Hospital Morgagni Pierantoni Forlì Italy
References provided by Crossref.org
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- $a Burisch, Johan $u Department of Gastroenterology, North Zealand Hospital, University of Copenhagen, Copenhagen, Denmark.
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- $a Disease course of inflammatory bowel disease unclassified in a European population-based inception cohort: An Epi-IBD study / $c J. Burisch, SC. Zammit, P. Ellul, S. Turcan, D. Duricova, M. Bortlik, KW. Andersen, V. Andersen, IP. Kaimakliotis, M. Fumery, C. Gower-Rousseau, G. Girardin, D. Valpiani, A. Goldis, M. Brinar, S. Čuković-Čavka, P. Oksanen, P. Collin, L. Barros, F. Magro, R. Misra, N. Arebi, C. Eriksson, J. Halfvarson, HAL. Kievit, N. Pedersen, J. Kjeldsen, S. Myers, S. Sebastian, KH. Katsanos, DK. Christodoulou, J. Midjord, KR. Nielsen, G. Kiudelis, L. Kupcinskas, I. Nikulina, E. Belousova, D. Schwartz, S. Odes, R. Salupere, A. Carmona, JR. Pineda, Z. Vegh, PL. Lakatos, E. Langholz, P. Munkholm, Epi-IBD group,
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- $a 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.
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