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Natural disease course of Crohn's disease during the first 5 years after diagnosis in a European population-based inception cohort: an Epi-IBD study

Ida Vind Niels Thorsgaard Riina Salupere Jongero Olsen Kari Rubek Nielsen Pia Oksanen Pekka Collin Konstantinnos H. Katsanos Dimitrios K. Christodoulou Alexandros Skamnelos Dimitrios Politis Karin Ladefoged 1 Peter Laszlo Lakatos Zsuzsanna Végh 2 Laszlo Lakatos Peterne Demenyi Szabina Nemethne Kramli Colm O'Morain 3 Giualia Dal Piaz Alessia Santini Giulia Girardin Renata d'Inca Doron Schwartz Selwyn Odes Limas Kupcinskas 4 Laimas Jonaitis 4 Gediminas Kiudelis Irena Valantiene Epi-Ibd Grp Johan Burisch Hendrika Adriana Linda Kievit Karina Winther Andersen Vibeke Andersen Natalia Pedersen Jens Kjeldsen Daniela Valpiani Alina Toca Svetlana Turcan Konstantinos H. Katsanos Mathurin Fumery 5, 6 Corinne Gower-Rousseau 7, 8, 9 Stefania Chetcuti Zammit Pierre Ellul 10 Carl Eriksson Jonas Halfvarson 11 Fernando Jose Magro Dana Duricova 7, 12 Martin Bortlik Alberto Fernández 13 Vicent Hernandez Sally Myers Shaji Sebastian 14 Adrian Goldis 15 Ravi Misra Naila Arebi Ioannis P. Kaimakliotis Inna Nikuina Elena Belousova 16 Marko Brinar Silvija Cukovic-Cavka Ebbe Langholz 17 Pia Munkholm Ola Niewiadomski Sally Bell Niksa Turk Ioannis Kaimakliotis Anastasia Nicolaou Milan Lukas 18 Olga Shonova Birgitte Blichfeldt Dorte Marker Katrine Carlsen Petra Weimers Clays Aalykke Jens Frederik Dahlerup 19 Karen Kudsk
Abstract : Objective The Epi-IBD cohort is a prospective population-based inception cohort of unselected patients with inflammatory bowel disease from 29 European centres covering a background population of almost 10 million people. The aim of this study was to assess the 5-year outcome and disease course of patients with Crohn's disease (CD). Design Patients were followed up prospectively from the time of diagnosis, including collection of their clinical data, demographics, disease activity, medical therapy, surgery, cancers and deaths. Associations between outcomes and multiple covariates were analysed by Cox regression analysis. Results In total, 488 patients were included in the study. During follow-up, 107 (22%) patients received surgery, while 176 (36%) patients were hospitalised because of CD. A total of 49 (14%) patients diagnosed with non-stricturing, non-penetrating disease progressed to either stricturing and/or penetrating disease. These rates did not differ between patients from Western and Eastern Europe. However, significant geographic differences were noted regarding treatment: more patients in Western Europe received biological therapy (33%) and immunomodulators (66%) than did those in Eastern Europe (14% and 54%, respectively, P<0.01), while more Eastern European patients received 5-aminosalicylates (90% vs 56%, P<0.05). Treatment with immunomodulators reduced the risk of surgery (HR: 0.4, 95% CI 0.2 to 0.6) and hospitalisation (HR: 0.3, 95% CI 0.2 to 0.5). Conclusion Despite patients being treated early and frequently with immunomodulators and biological therapy in Western Europe, 5-year outcomes including surgery and phenotype progression in this cohort were comparable across Western and Eastern Europe. Differences in treatment strategies between Western and Eastern European centres did not affect the disease course. Treatment with immunomodulators reduced the risk of surgery and hospitalisation.
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https://hal-u-picardie.archives-ouvertes.fr/hal-03552298
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Soumis le : mercredi 2 février 2022 - 11:19:10
Dernière modification le : mercredi 20 avril 2022 - 15:26:02

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Ida Vind, Niels Thorsgaard, Riina Salupere, Jongero Olsen, Kari Rubek Nielsen, et al.. Natural disease course of Crohn's disease during the first 5 years after diagnosis in a European population-based inception cohort: an Epi-IBD study. Gut, 2019, 68 (3), pp.423-433. ⟨10.1136/gutjnl-2017-315568⟩. ⟨hal-03552298⟩

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