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

Johan Burisch 1 Stefania Chetcuti Zammit 2 Pierre Ellul 2 Svetlana Turcan 3 Dana Duricova 4 Martin Bortlik 4, 5 Karina Winther Andersen 6 Vibeke Andersen 6, 7, 8 Ioannis P. Kaimakliotis Mathurin Fumery 9, 10 Corinne Gower-Rousseau 10, 11, 12 Giulia Girardin 13 Daniela Valpiani 14 Adrian Goldis 15 Marko Brinar 16 Silvija Cukovic-Cavka 16 Pia Oksanen 17, 18 Pekka Collin 17, 18 Luísa Barros 19 Fernando Magro 19, 20 Ravi Misra 21 Naila Arebi 21 Carl Eriksson 22 Jonas Halfvarson 22 Hendrika Adriana Linda Kievit 23 Natalia Pedersen Jens Kjeldsen 24 Sally Myers 25 Shaji Sebastian 25 Konstantinos H. Katsanos 26 Dimitrios K. Christodoulou 26 Jongerd Midjord 27 Kari Rubek Nielsen 27 Gediminas Kiudelis 28 Limas Kupcinskas 28 Inna Nikulina 29 Elena Belousova 29 Doron Schwartz 30 Selwyn Odes 30 Riina Salupere 31 Amalia Carmona Juan R. Pineda 32 Zsuzsanna Végh 33 Peter L. Lakatos 33, 34 Ebbe Langholz 1 Pia Munkholm 1 
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.
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Soumis le : mercredi 2 février 2022 - 11:18:59
Dernière modification le : mardi 30 août 2022 - 09:20:23

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Johan Burisch, Stefania Chetcuti Zammit, Pierre Ellul, Svetlana Turcan, Dana Duricova, et al.. Disease course of inflammatory bowel disease unclassified in a European population-based inception cohort: An Epi-IBD study. Journal of Gastroenterology and Hepatology, Wiley, 2019, 34 (6), pp.996-1003. ⟨10.1111/jgh.14563⟩. ⟨hal-03552292⟩

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