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The use of 5-aminosalicylate for patients with Crohn's disease in a prospective European inception cohort with 5 years follow-up - an Epi-IBD study

Johan Burisch Daniel Bergemalm 1 Jonas Halfvarson 1 Viktor Domislovic 2 Zeljko Krznaric 2, 3 Adrian Goldis 4 Jens F. Dahlerup 5 Pia Oksanen 6, 7 Pekka Collin 7 Luisa De Castro 8 Vicent Hernandez 8 Svetlana Turcan 9 Elena Belousova 10 Renata d'Inca 11 Alessandro Sartini 12 Daniela Valpiani 12 Martina Giannotta 13 Ravi Misra 14 Naila Arebi 14 Dana Duricova 15, 16 Martin Bortlik 15, 16 Kelly Gatt 17 Pierre Ellul 17 Natalia Pedersen Jens Kjeldsen 18 Karina W. Andersen 19 Vibeke Andersen 19 Konstantinos H. Katsanos 20 Dimitrios K. Christodoulou 20 Shaji Sebastian 21 Luisa Barros 22 Fernando Magro 22, 23 Jongero M. M. Midjord 24 Kari R. Nielsen 24 Riina Salupere 25 Hendrika A. L. Kievit 26 Gediminas Kiudelis 27 Juozas Kupcinskas 27 Mathurin Fumery 28 Corinne Gower-Rousseau 29, 30, 31 Ioannis P. Kaimakliotis Doron Schwartz 32 Selwyn Odes 32 Laszlo Lakatos Peter L. Lakatos 33, 34 Ebbe Langholz 35 Pia Munkholm 
Abstract : 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.
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Soumis le : mardi 1 février 2022 - 16:43:24
Dernière modification le : vendredi 25 novembre 2022 - 19:07:32

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Johan Burisch, Daniel Bergemalm, Jonas Halfvarson, Viktor Domislovic, Zeljko Krznaric, et al.. The use of 5-aminosalicylate for patients with Crohn's disease in a prospective European inception cohort with 5 years follow-up - an Epi-IBD study. United European Gastroenterology Journal, 2020, 8 (8), pp.949-960. ⟨10.1177/2050640620945949⟩. ⟨hal-03551526⟩



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