Disease course of inflammatory bowel disease unclassified in a European population-based inception cohort

An Epi-IBD study

Epi-IBD group

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

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.

OriginalsprogEngelsk
TidsskriftJournal of Gastroenterology and Hepatology
Vol/bind34
Udgave nummer6
Sider (fra-til)996-1003
ISSN0815-9319
DOI
StatusUdgivet - jun. 2019

Fingeraftryk

Inflammatory Bowel Diseases
Population
Ulcerative Colitis
Crohn Disease
Mesalamine
Delayed Diagnosis

Citer dette

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title = "Disease course of inflammatory bowel disease unclassified in a European population-based inception cohort: An Epi-IBD study",
abstract = "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.",
keywords = "inflammatory bowel disease unclassified, prognosis, treatment",
author = "Johan Burisch and {Chetcuti Zammit}, Stefania and Pierre Ellul and Svetlana Turcan and Dana Duricova and Martin Bortlik and {Winther Andersen}, Karina and Vibeke Andersen and Kaimakliotis, {Ioannis P} and Mathurin Fumery and Corinne Gower-Rousseau and Giulia Girardin and Daniela Valpiani and Adrian Goldis and Marko Brinar and Silvija Čuković-Čavka and Pia Oksanen and Pekka Collin and Luisa Barros and Fernando Magro and Ravi Misra and Naila Arebi and Carl Eriksson and Jonas Halfvarson and Kievit, {Hendrika Adriana Linda} and Natalia Pedersen and Jens Kjeldsen and Sally Myers and Shaji Sebastian and Katsanos, {Konstantinos H} and Christodoulou, {Dimitrios K} and J{\'o}nger{\dh} Midjord and Nielsen, {K{\'a}ri Rubek} and Gediminas Kiudelis and Limas Kupcinskas and Inna Nikulina and Elena Belousova and Doron Schwartz and Selwyn Odes and Riina Salupere and Amalia Carmona and Pineda, {Juan R} and Zsuzsanna Vegh and Lakatos, {Peter L} and Ebbe Langholz and Pia Munkholm and {Epi-IBD group}",
note = "This article is protected by copyright. All rights reserved.",
year = "2019",
month = "6",
doi = "10.1111/jgh.14563",
language = "English",
volume = "34",
pages = "996--1003",
journal = "Journal of Gastroenterology and Hepatology",
issn = "0815-9319",
publisher = "Wiley-Blackwell Publishing Asia",
number = "6",

}

Disease course of inflammatory bowel disease unclassified in a European population-based inception cohort : An Epi-IBD study. / Epi-IBD group.

I: Journal of Gastroenterology and Hepatology, Bind 34, Nr. 6, 06.2019, s. 996-1003.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Disease course of inflammatory bowel disease unclassified in a European population-based inception cohort

T2 - An Epi-IBD study

AU - Burisch, Johan

AU - Chetcuti Zammit, Stefania

AU - Ellul, Pierre

AU - Turcan, Svetlana

AU - Duricova, Dana

AU - Bortlik, Martin

AU - Winther Andersen, Karina

AU - Andersen, Vibeke

AU - Kaimakliotis, Ioannis P

AU - Fumery, Mathurin

AU - Gower-Rousseau, Corinne

AU - Girardin, Giulia

AU - Valpiani, Daniela

AU - Goldis, Adrian

AU - Brinar, Marko

AU - Čuković-Čavka, Silvija

AU - Oksanen, Pia

AU - Collin, Pekka

AU - Barros, Luisa

AU - Magro, Fernando

AU - Misra, Ravi

AU - Arebi, Naila

AU - Eriksson, Carl

AU - Halfvarson, Jonas

AU - Kievit, Hendrika Adriana Linda

AU - Pedersen, Natalia

AU - Kjeldsen, Jens

AU - Myers, Sally

AU - Sebastian, Shaji

AU - Katsanos, Konstantinos H

AU - Christodoulou, Dimitrios K

AU - Midjord, Jóngerð

AU - Nielsen, Kári Rubek

AU - Kiudelis, Gediminas

AU - Kupcinskas, Limas

AU - Nikulina, Inna

AU - Belousova, Elena

AU - Schwartz, Doron

AU - Odes, Selwyn

AU - Salupere, Riina

AU - Carmona, Amalia

AU - Pineda, Juan R

AU - Vegh, Zsuzsanna

AU - Lakatos, Peter L

AU - Langholz, Ebbe

AU - Munkholm, Pia

AU - Epi-IBD group

N1 - This article is protected by copyright. All rights reserved.

PY - 2019/6

Y1 - 2019/6

N2 - 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.

AB - 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.

KW - inflammatory bowel disease unclassified

KW - prognosis

KW - treatment

U2 - 10.1111/jgh.14563

DO - 10.1111/jgh.14563

M3 - Journal article

VL - 34

SP - 996

EP - 1003

JO - Journal of Gastroenterology and Hepatology

JF - Journal of Gastroenterology and Hepatology

SN - 0815-9319

IS - 6

ER -