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, Konstantinos H. Katsanos, Dimitrios K. Christodoulou, Luisa Barros, Fernando Magro, Natalia Pedersen, Jens Kjeldsen, Zsuzsanna Vegh, P. Lakatos, Carl Eriksson, Jonas Halfvarson, Mathurin Fumery, Corinne Gower-Rousseau, Marko Brinar, Silvija Čuković-Čavka, Inna Nikulina, Elena Belousova, Sally Myers, Shaji Sebastian, Gediminas KiudelisLimas Kupcinskas, Doron Schwartz, Selwyn Odes, Ioannis P. Kaimakliotis, Daniela Valpiani, Renata D'Incà, Riina Salupere, Stefania Chetcuti Zammit, Pierre Ellul, Dana Duricova, Martin Bortlik, Adrian Goldis, Hendrika Adriana Linda Kievit, Alina Toca, Svetlana Turcan, Jóngere Midjord, Kári Rubek Nielsen, Karina Winther Andersen, Vibeke Andersen, Ravi Misra, Naila Arebi, Pia Oksanen, Pekka Collin, Luisa De Castro, Vicent Hernandez, Ebbe Langholz, Pia Munkholm

Research output: Contribution to journalArticle

6 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)198-208
Number of pages11
JournalJournal of Crohn's and Colitis
Volume13
Issue number2
DOIs
Publication statusPublished - Feb 1 2019

Fingerprint

Ulcerative Colitis
Population
Immunologic Factors
Biological Therapy
Colitis
Hospitalization
Colectomy
Cohort Studies
Therapeutics
Regression Analysis
Demography

Keywords

  • biologics
  • hospitalisation
  • prognosis
  • surgery
  • treatment
  • Ulcerative colitis

ASJC Scopus subject areas

  • Gastroenterology

Cite this

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. / Burisch, Johan; Katsanos, Konstantinos H.; Christodoulou, Dimitrios K.; Barros, Luisa; Magro, Fernando; Pedersen, Natalia; Kjeldsen, Jens; Vegh, Zsuzsanna; Lakatos, P.; Eriksson, Carl; Halfvarson, Jonas; Fumery, Mathurin; Gower-Rousseau, Corinne; Brinar, Marko; Čuković-Čavka, Silvija; Nikulina, Inna; Belousova, Elena; Myers, Sally; Sebastian, Shaji; Kiudelis, Gediminas; Kupcinskas, Limas; Schwartz, Doron; Odes, Selwyn; Kaimakliotis, Ioannis P.; Valpiani, Daniela; D'Incà, Renata; Salupere, Riina; Chetcuti Zammit, Stefania; Ellul, Pierre; Duricova, Dana; Bortlik, Martin; Goldis, Adrian; Kievit, Hendrika Adriana Linda; Toca, Alina; Turcan, Svetlana; Midjord, Jóngere; Nielsen, Kári Rubek; Andersen, Karina Winther; Andersen, Vibeke; Misra, Ravi; Arebi, Naila; Oksanen, Pia; Collin, Pekka; De Castro, Luisa; Hernandez, Vicent; Langholz, Ebbe; Munkholm, Pia.

In: Journal of Crohn's and Colitis, Vol. 13, No. 2, 01.02.2019, p. 198-208.

Research output: Contribution to journalArticle

Burisch, J, Katsanos, KH, Christodoulou, DK, Barros, L, Magro, F, Pedersen, N, Kjeldsen, J, Vegh, Z, Lakatos, P, Eriksson, C, Halfvarson, J, Fumery, M, Gower-Rousseau, C, Brinar, M, Čuković-Čavka, S, Nikulina, I, Belousova, E, Myers, S, Sebastian, S, Kiudelis, G, Kupcinskas, L, Schwartz, D, Odes, S, Kaimakliotis, IP, Valpiani, D, D'Incà, R, Salupere, R, Chetcuti Zammit, S, Ellul, P, Duricova, D, Bortlik, M, Goldis, A, Kievit, HAL, Toca, A, Turcan, S, Midjord, J, Nielsen, KR, Andersen, KW, Andersen, V, Misra, R, Arebi, N, Oksanen, P, Collin, P, De Castro, L, Hernandez, V, Langholz, E & Munkholm, P 2019, '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, vol. 13, no. 2, pp. 198-208. https://doi.org/10.1093/ecco-jcc/jjy154
Burisch, Johan ; Katsanos, Konstantinos H. ; Christodoulou, Dimitrios K. ; Barros, Luisa ; Magro, Fernando ; Pedersen, Natalia ; Kjeldsen, Jens ; Vegh, Zsuzsanna ; Lakatos, P. ; Eriksson, Carl ; Halfvarson, Jonas ; Fumery, Mathurin ; Gower-Rousseau, Corinne ; Brinar, Marko ; Čuković-Čavka, Silvija ; Nikulina, Inna ; Belousova, Elena ; Myers, Sally ; Sebastian, Shaji ; Kiudelis, Gediminas ; Kupcinskas, Limas ; Schwartz, Doron ; Odes, Selwyn ; Kaimakliotis, Ioannis P. ; Valpiani, Daniela ; D'Incà, Renata ; Salupere, Riina ; Chetcuti Zammit, Stefania ; Ellul, Pierre ; Duricova, Dana ; Bortlik, Martin ; Goldis, Adrian ; Kievit, Hendrika Adriana Linda ; Toca, Alina ; Turcan, Svetlana ; Midjord, Jóngere ; Nielsen, Kári Rubek ; Andersen, Karina Winther ; Andersen, Vibeke ; Misra, Ravi ; Arebi, Naila ; Oksanen, Pia ; Collin, Pekka ; De Castro, Luisa ; Hernandez, Vicent ; Langholz, Ebbe ; Munkholm, Pia. / 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. In: Journal of Crohn's and Colitis. 2019 ; Vol. 13, No. 2. pp. 198-208.
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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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author = "Johan Burisch and Katsanos, {Konstantinos H.} and Christodoulou, {Dimitrios K.} and Luisa Barros and Fernando Magro and Natalia Pedersen and Jens Kjeldsen and Zsuzsanna Vegh and P. Lakatos and Carl Eriksson and Jonas Halfvarson and Mathurin Fumery and Corinne Gower-Rousseau and Marko Brinar and Silvija Čuković-Čavka and Inna Nikulina and Elena Belousova and Sally Myers and Shaji Sebastian and Gediminas Kiudelis and Limas Kupcinskas and Doron Schwartz and Selwyn Odes and Kaimakliotis, {Ioannis P.} and Daniela Valpiani and Renata D'Inc{\`a} and Riina Salupere and {Chetcuti Zammit}, Stefania and Pierre Ellul and Dana Duricova and Martin Bortlik and Adrian Goldis and Kievit, {Hendrika Adriana Linda} and Alina Toca and Svetlana Turcan and J{\'o}ngere Midjord and Nielsen, {K{\'a}ri Rubek} and Andersen, {Karina Winther} and Vibeke Andersen and Ravi Misra and Naila Arebi and Pia Oksanen and Pekka Collin and {De Castro}, Luisa and Vicent Hernandez and Ebbe Langholz and Pia Munkholm",
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TY - JOUR

T1 - 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

AU - Burisch, Johan

AU - Katsanos, Konstantinos H.

AU - Christodoulou, Dimitrios K.

AU - Barros, Luisa

AU - Magro, Fernando

AU - Pedersen, Natalia

AU - Kjeldsen, Jens

AU - Vegh, Zsuzsanna

AU - Lakatos, P.

AU - Eriksson, Carl

AU - Halfvarson, Jonas

AU - Fumery, Mathurin

AU - Gower-Rousseau, Corinne

AU - Brinar, Marko

AU - Čuković-Čavka, Silvija

AU - Nikulina, Inna

AU - Belousova, Elena

AU - Myers, Sally

AU - Sebastian, Shaji

AU - Kiudelis, Gediminas

AU - Kupcinskas, Limas

AU - Schwartz, Doron

AU - Odes, Selwyn

AU - Kaimakliotis, Ioannis P.

AU - Valpiani, Daniela

AU - D'Incà, Renata

AU - Salupere, Riina

AU - Chetcuti Zammit, Stefania

AU - Ellul, Pierre

AU - Duricova, Dana

AU - Bortlik, Martin

AU - Goldis, Adrian

AU - Kievit, Hendrika Adriana Linda

AU - Toca, Alina

AU - Turcan, Svetlana

AU - Midjord, Jóngere

AU - Nielsen, Kári Rubek

AU - Andersen, Karina Winther

AU - Andersen, Vibeke

AU - Misra, Ravi

AU - Arebi, Naila

AU - Oksanen, Pia

AU - Collin, Pekka

AU - De Castro, Luisa

AU - Hernandez, Vicent

AU - Langholz, Ebbe

AU - Munkholm, Pia

PY - 2019/2/1

Y1 - 2019/2/1

N2 - 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.

AB - 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.

KW - biologics

KW - hospitalisation

KW - prognosis

KW - surgery

KW - treatment

KW - Ulcerative colitis

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