Nejvíce citovaný článek - PubMed ID 30289522
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
BACKGROUND: The lack of scientific evidence regarding the effectiveness of 5-aminosalicylate in patients with Crohn's disease is in sharp contrast to its widespread use in clinical practice. AIMS: The aim of the study was to investigate the use of 5-aminosalicylate in patients with Crohn's disease as well as the disease course of a subgroup of patients who were treated with 5-aminosalicylate as maintenance monotherapy during the first year of disease. METHODS: In a European community-based inception cohort, 488 patients with Crohn's disease were followed from the time of their diagnosis. Information on clinical data, demographics, disease activity, medical therapy and rates of surgery, cancers and deaths was collected prospectively. Patient management was left to the discretion of the treating gastroenterologists. RESULTS: Overall, 292 (60%) patients with Crohn's disease received 5-aminosalicylate period during follow-up for a median duration of 28 months (interquartile range 6-60). Of these, 78 (16%) patients received 5-aminosalicylate monotherapy during the first year following diagnosis. Patients who received monotherapy with 5-aminosalicylate experienced a mild disease course with only nine (12%) who required hospitalization, surgery, or developed stricturing or penetrating disease, and most never needed more intensive therapy. The remaining 214 patients were treated with 5-aminosalicylate as the first maintenance drug although most eventually needed to step up to other treatments including immunomodulators (75 (35%)), biological therapy (49 (23%)) or surgery (38 (18%)). CONCLUSION: In this European community-based inception cohort of unselected Crohn's disease patients, 5-aminosalicylate was commonly used. A substantial group of these patients experienced a quiescent disease course without need of additional treatment during follow-up. Therefore, despite the controversy regarding the efficacy of 5-aminosalicylate in Crohn's disease, its use seems to result in a satisfying disease course for both patients and physicians.
- Klíčová slova
- 5-aminosalicylates, Population-based cohort, disease course,
- MeSH
- antiflogistika nesteroidní terapeutické užití MeSH
- biologické faktory terapeutické užití MeSH
- Crohnova nemoc diagnóza imunologie terapie MeSH
- dospělí MeSH
- hospitalizace statistika a číselné údaje MeSH
- imunologické faktory terapeutické užití MeSH
- kolektomie statistika a číselné údaje MeSH
- kombinovaná farmakoterapie metody statistika a číselné údaje MeSH
- lidé středního věku MeSH
- lidé MeSH
- mesalamin terapeutické užití MeSH
- mladý dospělý MeSH
- následné studie MeSH
- progrese nemoci MeSH
- prospektivní studie MeSH
- stupeň závažnosti nemoci MeSH
- udržovací chemoterapie metody statistika a číselné údaje MeSH
- výsledek terapie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- pozorovací studie MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Evropa MeSH
- Názvy látek
- antiflogistika nesteroidní MeSH
- biologické faktory MeSH
- imunologické faktory MeSH
- mesalamin MeSH