BACKGROUND AND AIMS: The ECCO-EpiCom study investigates the differences in the incidence and therapeutic management of inflammatory bowel diseases [IBD] between Eastern and Western Europe. The aim of this study was to analyse the differences in the disease phenotype, medical therapy, surgery, and hospitalization rates in the ECCO-EpiCom 2011 inception cohort during the first year after diagnosis. METHODS: Nine Western, five Eastern European centres and one Australian centre with 258 Crohn's disease [CD], 380 ulcerative colitis [UC] and 71 IBD unclassified [IBDU] patients [female/male: 326/383; mean age at diagnosis: 40.9 years, SD: 17.3 years] participated. Patients' data were registered and entered in the web-based ECCO-EpiCom database [www.epicom-ecco.eu]. RESULTS: In CD, 36 [19%] Western Europe/Australian and 6 [9%] Eastern European patients received biological therapy [p = 0.04], but the immunosuppressive [IS] use was equal and high in these regions [Eastern Europe vs Western Europe/Australia: 53% vs 45%; p = 0.27]. Surgery was performed in 17 [24%] CD patients in Eastern Europe and 13 [7%] in Western Europe/Australia [p < 0.001, pLogRank = 0.001]. Of CD patients from Eastern Europe, 24 [34%] were hospitalized, and 39 [21%] from Western Europe/Australia, [p = 0.02, pLogRank = 0.01]. In UC, exposure to biologicals and colectomy rates were low and hospitalization rates did not differ between these regions during the 1-year follow-up period [16% vs 16%; p = 0.93]. CONCLUSIONS: During the first year after diagnosis, surgery and hospitalization rates were significantly higher in CD patients in Eastern Europe compared with Western Europe/Australia, whereas significantly more CD patients were treated with biologicals in the Western Europe/Australian centres.

1st Department of Medicine Semmelweis University Budapest Hungary

1st Division of Internal Medicine and Division of Gastroenterology Faculty of Medicine University of Ioannina Ioannina Greece

Clinic of Gastroenterology University of Medicine 'Victor Babes' Timisoara Romania

Degenza Breve Internistica e Centro M 1 C 1 Azienda Ospedaliera Arcispedale S Maria Nuova Reggio Emilia Italy On behalf of the EpiCom Northern Italy centre based in Crema Cremona Firenze Forlì and Padova and Reggio Emilia Italy

Department C Gastroenterology Section Herlev and Gentofte Hospital Hellerup Denmark

Department of Gastroenterology and Hepatology Soroka Medical Centre and Ben Gurion University of the Negev Beer Sheva Israel

Department of Gastroenterology Grupo de Investigación en Patología Digestiva Instituto de Investigación Biomedica [IBI] Xerencia de Xestión Integrada de Vigo SERGAS Vigo Spain

Department of Gastroenterology Hospital de São João Porto Portugal Department of Pharmacology and Therapeutics Oporto Medical School Porto Portugal MedInUP Centre for Drug Discovery and Innovative Medicines University of Porto Porto Portugal

Department of Gastroenterology St Vincent's Hospital Melbourne Victoria Australia

Department of Gastroenterology State University of Medicine and Pharmacy Chisinau Republic of Moldova

Department of Medicine Amager Hospital Amager Denmark

Department of Medicine Csolnoky F Province Hospital Veszprem Hungary

Digestive Disease Centre Medical Section Herlev University Hospital Copenhagen Denmark

Gastro Unit Medical Section North Zealand Hospital University of Copenhagen Denmark

Gastroenterology Department Slagelse University Hospital Slagelse Denmark

Gastrounit Medical Section Hvidovre University Hospital Hvidovre Denmark

Hospital de Vale de Sousa Porto Portugal

IBD Centre ISCARE Charles University Prague Czech Republic

Institute for Digestive Research Lithuanian University of Health Sciences Kaunas Lithuania

Medical Department National Hospital of the Faroe Islands Torshavn Faroe Islands

Nicosia private practice Cyprus

UO Gastroenterologia Azienda Ospedaliera Università di Padova Padova Italy On behalf of the EpiCom Northern Italy centre based in Crema Cremona Firenze Forlì and Padova and Reggio Emilia Italy

J Crohns Colitis. 2015 Oct;9(10):939. doi: 10.1093/ecco-jcc/jjv160. PubMed

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