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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

Johan Burisch 1 Konstantinos H. Katsanos 2 Dimitrios K. Christodoulou 2 Luísa Barros 3 Fernando Magro 3, 4 Natalia Pedersen Jens Kjeldsen 5 Zsuzsanna Végh 6 Peter L. Lakatos 6, 7 Carl Eriksson 8 Jonas Halfvarson 8 Mathurin Fumery 9, 10 Corinne Gower-Rousseau 10, 11, 12 Marko Brinar 13, 14 Silvija Cukovic-Cavka 13, 14 Inna Nikulina 15 Elena Belousova 15 Sally Myers 16 Shaji Sebastian 16 Gediminas Kiudelis 17 Limas Kupcinskas 17 Doron Schwartz 18 Selwyn Odes 18 Ioannis P. Kaimakliotis Daniela Valpiani 19 Renata d'Inca 20 Riina Salupere 21 Stefania Chetcuti Zammit 22 Pierre Ellul 22 Dana Duricova 23 Martin Bortlik 23, 24 Adrian Goldis 25 Hendrika Adriana Linda Kievit 26 Alina Toca 27 Svetlana Turcan 27 Jongero Midjord 28 Kari Rubek Nielsen 28 Karina Winther Andersen 29 Vibeke Andersen 29, 30, 31 Ravi Misra 32 Naila Arebi 32 Pia Oksanen 33, 34 Pekka Collin 33, 34 Luisa De Castro 35 Vicent Hernandez 35 Ebbe Langholz 1 Pia Munkholm 1 
Abstract : Background and Aims: Few population-based cohort studies have assessed the disease course of ulcerative colitis [UC] in the era of biological therapy and widespread use of immunomodulators. The aim of this study was to assess the 5-year outcome and disease course of patients with UC in the Epi-IBD cohort. Methods: In a prospective, population-based inception cohort of unselected patients with UC, patients were followed up from the time of their diagnosis, which included the collection of their clinical data, demographics, disease activity, medical therapy, and rates of surgery, cancers, and deaths. Associations between outcomes and multiple covariates were analysed by Cox regression analysis. Results: A total of 717 patients were included in the study. During follow-up, 43 [6%] patients underwent a colectomy and 163 [23%] patients were hospitalised. Of patients with limited colitis [distal to the left flexure], 90 [21%] progressed to extensive colitis. In addition, 92 [27%] patients with extensive colitis experienced a regression in disease extent, which was associated with a reduced risk of hospitalisation (hazard ratio [HR]: 0.5 95% CI: 0.3-0.8]. Overall, patients were treated similarly in both geographical regions; 80 [11%] patients needed biological therapy and 210 [29%] patients received immunomodulators. Treatment with immunomodulators was found to reduce the risk of hospitalisation [HR: 0.5 95% CI: 0.3-0.8]. Conclusions: Although patients in this population-based cohort were treated more aggressively with immunomodulators and biological therapy than in cohorts from the previous two decades, their disease outcomes, including colectomy rates, were no different. However, treatment with immunomodulators was found to reduce the risk of hospitalisation.
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Soumis le : mercredi 2 février 2022 - 11:19:26
Dernière modification le : mardi 30 août 2022 - 09:08:24

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Johan Burisch, Konstantinos H. Katsanos, Dimitrios K. Christodoulou, Luísa Barros, Fernando Magro, et al.. 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. Journal of Crohn's and Colitis, Elsevier - Oxford University Press, 2019, 13 (2), pp.198-208. ⟨10.1093/ecco-jcc/jjy154⟩. ⟨hal-03552308⟩



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