2017
DOI: 10.1038/ajg.2016.524
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Abstract: Between 1991 and 2014, the hospitalization and surgery rates decreased, whereas progression to complicated disease is still common in CD. These improvements were not significantly related to the use of immunomodulators and biologicals.

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Cited by 124 publications
(120 citation statements)
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References 49 publications
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“…The use of biological therapy, however, was not associated with either surgery or hospitalisation. Furthermore, and similar to the findings of a recent Dutch population-based cohort,4 no regional difference in disease course was found despite significantly more frequent use of biological therapy in Western than in Eastern Europe.…”
Section: Discussionsupporting
confidence: 88%
See 1 more Smart Citation
“…The use of biological therapy, however, was not associated with either surgery or hospitalisation. Furthermore, and similar to the findings of a recent Dutch population-based cohort,4 no regional difference in disease course was found despite significantly more frequent use of biological therapy in Western than in Eastern Europe.…”
Section: Discussionsupporting
confidence: 88%
“…However, it remains uncertain whether the adoption of these treatment strategies have resulted in an improved long-term outcome of CD 4. To assess their impact on disease outcome, population-based prospective cohorts of unselected patients representing the broad spectrum of the disease are necessary in order to build the most accurate picture of effectiveness and practice regarding medication and surgery in the community setting.…”
Section: Introductionmentioning
confidence: 99%
“…Disease location in patients diagnosed with CD in western populations was evenly distributed at the time of diagnosis, with 27–42% presenting with ileal disease location, 28–35% with colonic location and 23–33% with ileocolonic location . While 1–6% of patients presented with upper gastrointestinal disease in Europe and North America, a higher proportion (22%) was reported in New Zealand.…”
Section: Clinical Features Of Ibdmentioning
confidence: 99%
“…While 1–6% of patients presented with upper gastrointestinal disease in Europe and North America, a higher proportion (22%) was reported in New Zealand. When looking at the disease behaviour of CD in the West, inflammatory disease behaviour was most common at the time of diagnosis (54–88%) . In the Epi‐IBD‐cohort, 29% of all CD patients presented with stricturing or penetrating disease with no significant differences found across Europe .…”
Section: Clinical Features Of Ibdmentioning
confidence: 99%
“…Recent epidemiological data indicate that biologicals have reduced the number of surgeries performed due to insufficient control of inflammation. However, despite effective and much better control of inflammation the development of CD in general from a B1 phenotype (only inflammatory) to a B2 (fibrotic) or B3 (penetrating) phenotype seems not to be significantly reduced (37, 38). This raises the important questions whether inflammatory mediators and molecules trigger the fibrotic process early and whether this process finally becomes independent from inflammation.…”
Section: Factors Activating Matrix-producing Cellsmentioning
confidence: 99%