Initial Disease Course and Treatment in an Inflammatory Bowel Disease Inception Cohort in Europe

Burisch, Johan; Pedersen, Natalia; Cukovic-Cavka, S.; Turk, Nikša; Kaimakliotis, Ioannis; Ďuricová, Dana; Shonová, Olga; Vind, Ida; Avnstrøm, Søren; Thorsgaard, Niels; Krabbe, Susanne; Andersen, Vibeke; Jens, Frederik Dahlerup; Kjeldsen, Jens; Salupere, Riina; Olsen, J; Nielsen, K R; Manninen, Pia; Collin, Pekka; Katsanos, K.; Tsianos, Epameinondas V.; Ladefoged, Karin; Lakatos, László; Bailey, Yvonne; O’Moráin, Colm; Schwartz, Doron; Odes, Selwyn; Martinato, Matteo; Lombardini, S.; Jonaitis, Laimas Virginijus; Kupčinskas, Limas; Turcan, Svetlana; Barros, Louisa; Magro, Fernando; Lazăr, Daniela; Goldiş, Adrian; Nikulina, Inna; Belousova, Elena; Fernández, Alberto; Hernández, Vicent; Almér, Sven; Zhulina, Yaroslava; Halfvarson, Jonas; Tsai, Her Hsin; Sebastian, Shaji; Lakatos, Péter L.; Langholz, Ebbe; Munkholm, Pia

doi:10.1097/01.mib.0000436277.13917.c4

Cited by 76 publications

(73 citation statements)

References 41 publications

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“…Furthermore, hospitalization rates decreased after the first year of the diagnosis. Finally, even lower early hospitalization rates were reported in the very recent, populationbased EpiCom study in patients diagnosed in 2010 [21] . Cumulative CD-related hospitalization rates were 20% and 16% in western and eastern European centers, with 42% and 35% of events related to surgery, respectively.…”

Section: Discussionmentioning

confidence: 74%

Prevalence and predictors of hospitalization in Crohn’s disease in a prospective population-based inception cohort from 2000-2012

Golovics¹,

Lakatos²,

Mandel³

et al. 2015

WJG

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AIM:To analyze the prevalence, length and predictors of hospitalization in the biological era in the populationbased inception cohort from Veszprem province. METHODS:Data of 331 incident Crohn's disease (CD) patients diagnosed between January 1, 2000 and December 31, 2010 were analyzed (median age at diagnosis: 28; IQR: 21-40 years). Both in-and outpatient records were collected and comprehensively reviewed. RESULTS:Probabilities of first CD-related hospitalization and re-hospitalization were 32.3%, 45.5%, 53.7% and 13.6%, 23.9%, 29.8%, respectively after one, three and five years of follow-up in Kaplan-Meier analysis. First-year hospitalizations were related to diagnostic procedures (37%), surgery or disease activity (27% and 21%). Non-inflammatory disease behavior at diagnosis (HR = 1.32, P = 0.001) and perianal disease (HR = 1.47, P = 0.04) were associated with time to first CD-related hospitalization, while disease behavior change (HR = 2.38, P = 0.002) and need for steroids (HR = 3.14, P = 0.003) were associated with time to first re-hospitalization in multivariate analyses. Early CD-related hospitalization (within the year of diagnosis) was independently associated with need for immunosuppressives (OR = 2.08, P = 0.001) and need for surgeries (OR = 7.25, P < 0.001) during the disease course. Observational Study Prevalence and predictors of hospitalization in CONCLUSION:Hospitalization and re-hospitalization rates are still high in this cohort, especially during the first-year after the diagnosis. Non-inflammatory disease behavior at diagnosis was identified as the pivotal predictive factor of both hospitalization and rehospitalization. Core tip: Recent data on hospitalization rates in Crohn' s disease (CD) are lacking from population-based studies. In the present study our aim was to analyze the prevalence, cause and predictors of hospitalization and re-hospitalization in the population-based inception cohort from Veszprem province. Relatively high rates of CD-related hospitalizations and re-hospitalizations were found in our cohort, especially during the first year after the diagnosis. Non-inflammatory disease behavior at diagnosis, behavior change in patients with initial B1 behavior, perianal disease and total AZA and anti-TNF exposure was associated with the time to first CD-related hospitalization. Early CD-related hospitalization was associated with non-inflammatory disease behavior, perianal or internal fistulizing disease, need for immunosuppressives and need for surgeries during the disease course. Key words:Golovics PA, Lakatos L, Mandel MD, Lovasz BD, Vegh Z, Kurti Z, Szita I, Kiss LS, Pandur T, Lakatos PL. Prevalence and predictors of hospitalization in Crohn's disease in a prospective population-based inception cohort from

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Section: Discussionmentioning

confidence: 74%

Prevalence and predictors of hospitalization in Crohn’s disease in a prospective population-based inception cohort from 2000-2012

Golovics¹,

Lakatos²,

Mandel³

et al. 2015

WJG

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“…Two recent population-based cohorts demonstrated a significant reduction in surgery rates in CD over time to be associated with increased and earlier use of thiopurines,16 21 while a beneficial effect on the early disease course could not be demonstrated in two randomised, controlled trials 29 30. In the present cohort, treatment with immunomodulators, as well as biologicals, was initiated early in the disease course 31. Immunomodulators were found to significantly reduce the risk of surgery and hospitalisation while it non-significantly reduced the risk of progression.…”

Section: Discussionmentioning

confidence: 85%

Natural disease course of Crohn’s disease during the first 5 years after diagnosis in a European population-based inception cohort: an Epi-IBD study

Burisch

Kiudelis

Kupčinskas

et al. 2018

Gut

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178

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Despite patients being treated early and frequently with immunomodulators and biological therapy in Western Europe, 5-year outcomes including surgery and phenotype progression in this cohort were comparable across Western and Eastern Europe. Differences in treatment strategies between Western and Eastern European centres did not affect the disease course. Treatment with immunomodulators reduced the risk of surgery and hospitalisation.

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“…[15] A similar operation frequency of 7.6% after five years was reported from a Canadian study of patients diagnosed between the years 1984 and 2008. [16] Although only providing 1-year data, the ECCO-Epicom studies reporting the outcome of patients diagnosed 2010 and 2011 [17,18] demonstrate an operation frequency of 3% and 0.4%, respectively.…”

Section: Scandinavian Journal Of Gastroenterologymentioning

confidence: 99%

Low colectomy rate five years after diagnosis of ulcerative colitis. Results from a prospective population-based cohort in Sweden (ICURE) diagnosed during 2005–2009*

Rönnblom

Holmström²,

Tanghöj

et al. 2016

Scandinavian Journal of Gastroenterology

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Initial Disease Course and Treatment in an Inflammatory Bowel Disease Inception Cohort in Europe

Cited by 76 publications

References 41 publications

Prevalence and predictors of hospitalization in Crohn’s disease in a prospective population-based inception cohort from 2000-2012

Prevalence and predictors of hospitalization in Crohn’s disease in a prospective population-based inception cohort from 2000-2012

Natural disease course of Crohn’s disease during the first 5 years after diagnosis in a European population-based inception cohort: an Epi-IBD study

Low colectomy rate five years after diagnosis of ulcerative colitis. Results from a prospective population-based cohort in Sweden (ICURE) diagnosed during 2005–2009*

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