Natural Disease Course of Ulcerative Colitis During the First Five Years of Follow-up in a European Population-based Inception Cohort-An Epi-IBD Study
Language English Country England, Great Britain Media print
Document type Journal Article
PubMed
30289522
DOI
10.1093/ecco-jcc/jjy154
PII: 5115808
Knihovny.cz E-resources
- MeSH
- Adult MeSH
- Gastrointestinal Agents therapeutic use MeSH
- Hospitalization statistics & numerical data MeSH
- Immunologic Factors therapeutic use MeSH
- Colectomy statistics & numerical data MeSH
- Middle Aged MeSH
- Humans MeSH
- Follow-Up Studies MeSH
- Disease Progression MeSH
- Prospective Studies MeSH
- Colitis, Ulcerative pathology therapy MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Geographicals
- Europe MeSH
- Names of Substances
- Gastrointestinal Agents MeSH
- Immunologic Factors MeSH
BACKGROUND AND AIMS: Few population-based cohort studies have assessed the disease course of ulcerative colitis [UC] in the era of biological therapy and widespread use of immunomodulators. The aim of this study was to assess the 5-year outcome and disease course of patients with UC in the Epi-IBD cohort. METHODS: In a prospective, population-based inception cohort of unselected patients with UC, patients were followed up from the time of their diagnosis, which included the collection of their clinical data, demographics, disease activity, medical therapy, and rates of surgery, cancers, and deaths. Associations between outcomes and multiple covariates were analysed by Cox regression analysis. RESULTS: A total of 717 patients were included in the study. During follow-up, 43 [6%] patients underwent a colectomy and 163 [23%] patients were hospitalised. Of patients with limited colitis [distal to the left flexure], 90 [21%] progressed to extensive colitis. In addition, 92 [27%] patients with extensive colitis experienced a regression in disease extent, which was associated with a reduced risk of hospitalisation (hazard ratio [HR]: 0.5 95% CI: 0.3-0.8]. Overall, patients were treated similarly in both geographical regions; 80 [11%] patients needed biological therapy and 210 [29%] patients received immunomodulators. Treatment with immunomodulators was found to reduce the risk of hospitalisation [HR: 0.5 95% CI: 0.3-0.8]. CONCLUSIONS: Although patients in this population-based cohort were treated more aggressively with immunomodulators and biological therapy than in cohorts from the previous two decades, their disease outcomes, including colectomy rates, were no different. However, treatment with immunomodulators was found to reduce the risk of hospitalisation.
1st Department of Medicine Semmelweis University Budapest Hungary
American Gastroenterology Center Nicosia Cyprus
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 Moscow Regional Research Clinical Institute Moscow Russian Federation
Department of Gastroenterology Nordsjællands Hospital University of Copenhagen Frederikssund 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 McGill University Health Center Montreal QC Canada
Division of Gastroenterology Tartu University Hospital University of Tartu Tartu Estonia
Gastroenterology Department Odense University Hospital Odense Denmark
Gastroenterology Department Slagelse Hospital Slagelse Denmark
Gastroenterology Unit Epimad Registry CHU Amiens Sud Amiens University Hospital Amiens France
IBD Clinical and Research Centre ISCARE Prague Czech Republic
IBD Department St Mark's Hospital London UK
IBD Unit Hull and East Yorkshire NHS Trust Hull UK
Institute of Molecular Medicine University of Southern Denmark Odense Denmark
Institute of Pharmacology 1st Faculty of Medicine Charles University Prague Prague Czech Republic
Lille Inflammation Research International Center LIRIC Lille University Lille France
Medical Department National Hospital of the Faroe Islands Torshavn Faroe Islands
Medical Department Regional Hospital of Viborg Viborg Denmark
School of Medicine University of Zagreb Zagreb Croatia
U O Gastroenterologia ed Endoscopia digestiva Hospital Morgagni Pierantoni Forlì Italy
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