Johan Burisch1, Daniel Bergemalm2, Jonas Halfvarson2, Viktor Domislovic3, Zeljko Krznaric3,4, Adrian Goldis5, Jens F Dahlerup6, Pia Oksanen7,8, Pekka Collin8, Luisa de Castro9,10, Vicent Hernandez9,10, Svetlana Turcan11, Elena Belousova12, Renata D'Incà13, Alessandro Sartini14, Daniela Valpiani14, Martina Giannotta15, Ravi Misra16, Naila Arebi16, Dana Duricova17,18, Martin Bortlik17,18, Kelly Gatt19, Pierre Ellul19, Natalia Pedersen20, Jens Kjeldsen21, Karina W Andersen22, Vibeke Andersen22,23, Konstantinos H Katsanos24, Dimitrios K Christodoulou24, Shaji Sebastian25,26, Luisa Barros27, Fernando Magro27,28, Jóngerð Mm Midjord29, Kári R Nielsen29, Riina Salupere30, Hendrika Al Kievit31, Gediminas Kiudelis32, Juozas Kupčinskas32,33, Mathurin Fumery34, Corinne Gower-Rousseau35,36, Ioannis P Kaimakliotis37, Doron Schwartz38, Selwyn Odes39, Laszlo Lakatos40, Peter L Lakatos41,42, Ebbe Langholz43, Pia Munkholm1. 1. Department of Gastroenterology, North Zealand University Hospital, Frederikssund, Denmark. 2. Department of Gastroenterology, Örebro University, Örebro, Sweden. 3. Department of Gastroenterology, Hepatology and Nutrition, 162072University Hospital Centre Zagreb, Zagreb, Croatia. 4. School of Medicine, University of Zagreb, Zagreb, Croatia. 5. Clinic of Gastroenterology, University of Medicine 'Victor Babes', Timisoara, Romania. 6. Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark. 7. Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Tampere, Finland. 8. Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland. 9. Digestive Diseases Research Group, Galicia Sur Health Research Institute (IIS Galicia Sur), Vigo, Spain. 10. Department of Gastroenterology, Complexo Hospitalario Universitario de Vigo, Vigo, Spain. 11. Department of Gastroenterology, State University of Medicine and Pharmacy of the Republic of Moldova, Chisinau, Republic of Moldova. 12. Department of Gastroenterology, Moscow Regional Research Clinical Institute, Moscow, Russian Federation. 13. Department of Surgical, Oncological and Gastroenterological Sciences, University of Padua, Padova, Italy. 14. UO Gastroenterologia ed Endoscopia digestiva, Hospital Morgagni Pierantoni, Forlì, Italy. 15. Department of Gastroenterology, Azienda USL Toscana Centro, Florence, Italy. 16. IBD Department, Imperial College London, London, UK. 17. IBD Clinical and Research Centre, ISCARE, Prague, Czech Republic. 18. Institute of Pharmacology, Charles University in Prague, Prague, Czech Republic. 19. Division of Gastroenterology, 223089Mater Dei Hospital, Msida, Malta. 20. Gastroenterology Department, Slagelse Hospital, Slagelse, Denmark. 21. Gastroenterology Department, Odense University Hospital, Odense, Denmark. 22. IRS-Center Soenderjylland, University Hospital of Southern Denmark, Aabenraa, Denmark. 23. Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark. 24. Division of Gastroenterology, University Hospital and University of Ioannina, Greece. 25. Hull University Teaching Hospitals NHS Trust, Hull, UK. 26. Hull York Medical School, Hull, UK. 27. Department of Gastroenterology, Centro Hospitalar de São João EPE, Porto, Portugal. 28. Department of Biomedicine, Porto University, Porto, Portugal. 29. Medical Department, The National Hospital of the Faroe Islands, Torshavn, Faroe Islands. 30. Division of Gastroenterology, University of Tarty, Tartu, Estonia. 31. Department of Medicine, Herning Central Hospital, Herning, Denmark. 32. Department of Gastroenterology, Lithuanian University of Health Sciences, Kaunas, Lithuania. 33. Institute for Digestive Research, Lithuanian University of Health Sciences, Kaunas, Lithuania. 34. Gastroenterology Unit, 26993Amiens University Hospital, Amiens, France. 35. Public Health, Epidemiology and Economic Health, Lille University and Hospital, Lille, France. 36. Institute for Translational Research in Inflammation (Infinite), Lille University, Lille, France. 37. Private practice, Nicosia, Cyprus. 38. Department of Gastroenterology and Liver Diseases, 26732Ben-Gurion University of the Negev, Beer Sheva, Israel. 39. Department of Internal Medicine, 26732Ben-Gurion University of the Negev, Beer Sheva, Israel. 40. Department of Internal Medicine, Csolnoky Ferenc Regional Hospital, Veszprem, Hungary. 41. 1st Department of Medicine, Semmelweis University, Budapest, Hungary. 42. Division of Gastroenterology, McGill University Health Center, Montreal, Canada. 43. Department of Gastroenterology, 53176Herlev Hospital, University of Copenhagen, Denmark.
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.
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 diseasepatients, 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.
Authors: Johan Burisch; Gediminas Kiudelis; Limas Kupcinskas; Hendrika Adriana Linda Kievit; Karina Winther Andersen; Vibeke Andersen; Riina Salupere; Natalia Pedersen; Jens Kjeldsen; Renata D'Incà; Daniela Valpiani; Doron Schwartz; Selwyn Odes; Jóngerð Olsen; Kári Rubek Nielsen; Zsuzsanna Vegh; Peter Laszlo Lakatos; Alina Toca; Svetlana Turcan; Konstantinos H Katsanos; Dimitrios K Christodoulou; Mathurin Fumery; Corinne Gower-Rousseau; Stefania Chetcuti Zammit; Pierre Ellul; Carl Eriksson; Jonas Halfvarson; Fernando Jose Magro; Dana Duricova; Martin Bortlik; Alberto Fernandez; Vicent Hernández; Sally Myers; Shaji Sebastian; Pia Oksanen; Pekka Collin; Adrian Goldis; Ravi Misra; Naila Arebi; Ioannis P Kaimakliotis; Inna Nikuina; Elena Belousova; Marko Brinar; Silvija Cukovic-Cavka; Ebbe Langholz; Pia Munkholm Journal: Gut Date: 2018-01-23 Impact factor: 23.059
Authors: Kelvin T Thia; William J Sandborn; William S Harmsen; Alan R Zinsmeister; Edward V Loftus Journal: Gastroenterology Date: 2010-07-14 Impact factor: 22.682
Authors: J Burisch; N Pedersen; S Čuković-Čavka; M Brinar; I Kaimakliotis; D Duricova; O Shonová; I Vind; S Avnstrøm; N Thorsgaard; V Andersen; S Krabbe; J F Dahlerup; R Salupere; K R Nielsen; J Olsen; P Manninen; P Collin; E V Tsianos; K H Katsanos; K Ladefoged; L Lakatos; E Björnsson; G Ragnarsson; Y Bailey; S Odes; D Schwartz; M Martinato; G Lupinacci; M Milla; A De Padova; R D'Incà; M Beltrami; L Kupcinskas; G Kiudelis; S Turcan; O Tighineanu; I Mihu; F Magro; L F Barros; A Goldis; D Lazar; E Belousova; I Nikulina; V Hernandez; D Martinez-Ares; S Almer; Y Zhulina; J Halfvarson; N Arebi; S Sebastian; P L Lakatos; E Langholz; P Munkholm Journal: Gut Date: 2013-04-20 Impact factor: 23.059
Authors: Åsa H Everhov; Jonas Halfvarson; Pär Myrelid; Michael C Sachs; Caroline Nordenvall; Jonas Söderling; Anders Ekbom; Martin Neovius; Jonas F Ludvigsson; Johan Askling; Ola Olén Journal: Gastroenterology Date: 2017-11-02 Impact factor: 22.682
Authors: Ryan C Ungaro; Berkeley N Limketkai; Camilla Bjørn Jensen; Clara Yzet; Kristine H Allin; Manasi Agrawal; Thomas Ullman; Johan Burisch; Tine Jess; Jean-Frederic Colombel Journal: Clin Gastroenterol Hepatol Date: 2019-08-13 Impact factor: 11.382
Authors: V Chhaya; S Saxena; E Cecil; V Subramanian; V Curcin; A Majeed; R C Pollok Journal: Aliment Pharmacol Ther Date: 2016-07-04 Impact factor: 8.171