Johan Burisch1, Konstantinos H Katsanos2, Dimitrios K Christodoulou2, Luisa Barros3, Fernando Magro3,4, Natalia Pedersen5, Jens Kjeldsen6, Zsuzsanna Vegh7, Peter L Lakatos7,8, Carl Eriksson9, Jonas Halfvarson9, Mathurin Fumery10, Corinne Gower-Rousseau11,12, Marko Brinar13,14, Silvija Cukovic-Cavka13,14, Inna Nikulina15, Elena Belousova15, Sally Myers16, Shaji Sebastian16, Gediminas Kiudelis17, Limas Kupcinskas17,18, Doron Schwartz19, Selwyn Odes19, Ioannis P Kaimakliotis20, Daniela Valpiani21, Renata D'Incà22, Riina Salupere23, Stefania Chetcuti Zammit24, Pierre Ellul24, Dana Duricova25, Martin Bortlik25,26, Adrian Goldis27, Hendrika Adriana Linda Kievit28, Alina Toca29, Svetlana Turcan29, Jóngerð Midjord30, Kári Rubek Nielsen30, Karina Winther Andersen31, Vibeke Andersen31,32,33, Ravi Misra34, Naila Arebi34, Pia Oksanen35,36, Pekka Collin35,36, Luisa de Castro37, Vicent Hernandez37, Ebbe Langholz38, Pia Munkholm1. 1. Department of Gastroenterology, Nordsjællands Hospital, University of Copenhagen, Frederikssund, Denmark. 2. Department of Gastroenterology, University Hospital of Ioannina, Ioannina, Greece. 3. Department of Gastroenterology, Centro Hospitalar de São João EPE, Porto, Portugal. 4. Department of Biomedicine, Institute of Pharmacology, Faculty of Medicine of Porto University, Porto, Portugal. 5. Gastroenterology Department, Slagelse Hospital, Slagelse, Denmark. 6. Gastroenterology Department, Odense University Hospital, Odense, Denmark. 7. First Department of Medicine, Semmelweis University, Budapest, Hungary. 8. Division of Gastroenterology, McGill University Health Center, Montreal, QC, Canada. 9. Department of Gastroenterology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden. 10. Gastroenterology Unit, Epimad Registry, CHU Amiens Sud, Amiens University Hospital, Amiens, France. 11. Public Health, Epidemiology and Economic Health, Registre Epimad, Lille University and Hospital, Lille, France. 12. Lille Inflammation Research International Center LIRIC, Lille University, Lille, France. 13. Division of Gastroenterology and Hepatology, University Hospital Center Zagreb, Zagreb, Croatia. 14. School of Medicine, University of Zagreb, Zagreb, Croatia. 15. Department of Gastroenterology, Moscow Regional Research Clinical Institute, Moscow, Russian Federation. 16. IBD Unit, Hull and East Yorkshire NHS Trust, Hull, UK. 17. Institute for Digestive Research, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania. 18. Department of Gastroenterology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania. 19. Department of Gastroenterology and Hepatology, Soroka Medical Center and Ben Gurion University of the Negev, Beer Sheva, Israel. 20. American Gastroenterology Center, Nicosia, Cyprus. 21. U.O. Gastroenterologia ed Endoscopia digestiva, Hospital Morgagni Pierantoni, Forlì, Italy. 22. Department of Surgical, Oncological and Gastroenterological Sciences, Azienda, University of Padua, Padova, Italy. 23. Division of Gastroenterology, Tartu University Hospital, University of Tartu, Tartu, Estonia. 24. Division of Gastroenterology, Mater Dei Hospital, Msida, Malta. 25. IBD Clinical and Research Centre, ISCARE, Prague, Czech Republic. 26. Institute of Pharmacology, First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic. 27. Clinic of Gastroenterology, University of Medicine 'Victor Babes', Timisoara, Romania. 28. Department of Medicine, Herning Central Hospital, Herning, Denmark. 29. Department of Gastroenterology, State University of Medicine and Pharmacy of the Republic of Moldova, Chisinau, Republic of Moldova. 30. Medical Department, National Hospital of the Faroe Islands, Torshavn, Faroe Islands. 31. Medical Department, Regional Hospital of Viborg, Viborg, Denmark. 32. Focused Research Unit for Molecular Diagnostic and Clinical Research [MOK], IRS-Center Sonderjylland, Hospital of Southern Jutland, Aabenraa, Denmark. 33. Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark. 34. IBD Department, St Mark's Hospital, London, UK. 35. Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Tampere, Finland. 36. University of Tampere, Tampere, Finland. 37. Department of Gastroenterology. Hospital Alvaro Cunqueiro, Instituto Investigación Sanitaria Galicia Sur, EOXI de Vigo, Vigo, Spain. 38. Department of Gastroenterology, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark.
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.
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.
Authors: Johan Burisch; Daniel Bergemalm; Jonas Halfvarson; Viktor Domislovic; Zeljko Krznaric; Adrian Goldis; Jens F Dahlerup; Pia Oksanen; Pekka Collin; Luisa de Castro; Vicent Hernandez; Svetlana Turcan; Elena Belousova; Renata D'Incà; Alessandro Sartini; Daniela Valpiani; Martina Giannotta; Ravi Misra; Naila Arebi; Dana Duricova; Martin Bortlik; Kelly Gatt; Pierre Ellul; Natalia Pedersen; Jens Kjeldsen; Karina W Andersen; Vibeke Andersen; Konstantinos H Katsanos; Dimitrios K Christodoulou; Shaji Sebastian; Luisa Barros; Fernando Magro; Jóngerð Mm Midjord; Kári R Nielsen; Riina Salupere; Hendrika Al Kievit; Gediminas Kiudelis; Juozas Kupčinskas; Mathurin Fumery; Corinne Gower-Rousseau; Ioannis P Kaimakliotis; Doron Schwartz; Selwyn Odes; Laszlo Lakatos; Peter L Lakatos; Ebbe Langholz; Pia Munkholm Journal: United European Gastroenterol J Date: 2020-07-26 Impact factor: 4.623
Authors: Mohamed Attauabi; Gorm Roager Madsen; Flemming Bendtsen; Anne Vibeke Wewer; Rune Wilkens; Johan Ilvemark; Nora Vladimirova; Annette Bøjer Jensen; Frank Krieger Jensen; Sanja Bay Hansen; Hartwig Roman Siebner; Yousef Jesper Wirenfeldt Nielsen; Jakob M Møller; Henrik S Thomsen; Simon Francis Thomsen; Helene Andrea Sinclair Ingels; Klaus Theede; Trine Boysen; Jacob T Bjerrum; Christian Jakobsen; Maria Dorn-Rasmussen; Sabine Jansson; Yiqiu Yao; Ewa Anna Burian; Frederik Trier Møller; Viktoria Fana; Charlotte Wiell; Lene Terslev; Mikkel Østergaard; Kristina Bertl; Andreas Stavropoulos; Jakob B Seidelin; Johan Burisch Journal: BMJ Open Date: 2022-06-27 Impact factor: 3.006
Authors: David Marti-Aguado; María Pilar Ballester; Joan Tosca; Marta Maia Bosca-Watts; Pablo Navarro; Rosario Anton; Isabel Pascual; Francisco Mora; Miguel Minguez Journal: United European Gastroenterol J Date: 2019-05-29 Impact factor: 4.623
Authors: María Chaparro; Ana Garre; Andrea Núñez Ortiz; María Teresa Diz-Lois Palomares; Cristina Rodríguez; Sabino Riestra; Milagros Vela; José Manuel Benítez; Estela Fernández Salgado; Eugenia Sánchez Rodríguez; Vicent Hernández; Rocío Ferreiro-Iglesias; Ángel Ponferrada Díaz; Jesús Barrio; José María Huguet; Beatriz Sicilia; María Dolores Martín-Arranz; Xavier Calvet; Daniel Ginard; Inmaculada Alonso-Abreu; Luis Fernández-Salazar; Pilar Varela Trastoy; Montserrat Rivero; Isabel Vera-Mendoza; Pablo Vega; Pablo Navarro; Mónica Sierra; José Luis Cabriada; Mariam Aguas; Raquel Vicente; Mercè Navarro-Llavat; Ana Echarri; Fernando Gomollón; Elena Guerra Del Río; Concepción Piñero; María José Casanova; Katerina Spicakova; Jone Ortiz de Zarate; Emilio Torrella Cortés; Ana Gutiérrez; Horacio Alonso-Galán; Álvaro Hernández-Martínez; José Miguel Marrero; Rufo Lorente Poyatos; Margalida Calafat; Lidia Martí Romero; Pilar Robledo; Orencio Bosch; Nuria Jiménez; María Esteve Comas; José María Duque; Ana María Fuentes Coronel; Manuela Josefa Sampedro; Eva Sesé Abizanda; Belén Herreros Martínez; Liliana Pozzati; Hipólito Fernández Rosáenz; Belén Crespo Suarez; Pilar López Serrano; Alfredo J Lucendo; Margarita Muñoz Vicente; Fernando Bermejo; José Joaquín Ramírez Palanca; Margarita Menacho; Amalia Carmona; Raquel Camargo; Sandra Torra Alsina; Nuria Maroto; Juan Nerín de la Puerta; Elena Castro; Ignacio Marín-Jiménez; Belén Botella; Amparo Sapiña; Noelia Cruz; José Luis F Forcelledo; Abdel Bouhmidi; Carlos Castaño-Milla; Verónica Opio; Isabel Nicolás; Marcos Kutz; Alfredo Abraldes Bechiarelli; Jordi Gordillo; Yolanda Ber; Yolanda Torres Domínguez; María Teresa Novella Durán; Silvia Rodríguez Mondéjar; Francisco J Martínez-Cerezo; Lilyan Kolle; Miriam Sabat; Cesar Ledezma; Eduardo Iyo; Óscar Roncero; Rebeca Irisarri; Laia Lluis; Isabel Blázquez Gómez; Eva María Zapata; María José Alcalá; Cristina Martínez Pascual; María Montealegre; Laura Mata; Ana Monrobel; Alejandro Hernández Camba; Luis Hernández; María Tejada; Alberto Mir; María Luisa Galve; Marta Soler; Daniel Hervías; José Antonio Gómez-Valero; Manuel Barreiro-de Acosta; Fernando Rodríguez-Artalejo; Esther García-Esquinas; Javier P Gisbert Journal: J Clin Med Date: 2021-06-29 Impact factor: 4.964