Disease course of inflammatory bowel disease unclassified in a European population-based inception cohort : An Epi-IBD study

© 2018 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd..

BACKGROUND AND AIM: A definitive diagnosis of Crohn's disease (CD) or ulcerative colitis (UC) is not always possible, and a proportion of patients will be diagnosed as inflammatory bowel disease unclassified (IBDU). The aim of the study was to investigate the prognosis of patients initially diagnosed with IBDU and the disease course during the following 5 years.

METHODS: The Epi-IBD study is a prospective population-based cohort of 1289 IBD patients diagnosed in centers across Europe. Clinical data were captured prospectively throughout the follow-up period.

RESULTS: Overall, 476 (37%) patients were initially diagnosed with CD, 701 (54%) with UC, and 112 (9%) with IBDU. During follow-up, 28 (25%) IBDU patients were changed diagnoses to either UC (n = 20, 71%) or CD (n = 8, 29%) after a median of 6 months (interquartile range: 4-12), while 84 (7% of the total cohort) remained IBDU. A total of 17 (15%) IBDU patients were hospitalized for their IBD during follow-up, while 8 (7%) patients underwent surgery. Most surgeries (n = 6, 75%) were performed on patients whose diagnosis was later changed to UC; three of these colectomies led to a definitive diagnosis of UC. Most patients (n = 107, 96%) received 5-aminosalicylic acid, while 11 (10%) patients received biologicals, of whom five remained classified as IBDU.

CONCLUSIONS: In a population-based inception cohort, 7% of IBD patients were not given a definitive diagnosis of IBD after 5 years of follow-up. One in four patients with IBDU eventually was classified as CD or UC. Overall, the disease course and medication burden in IBDU patients were mild.

Media Type:

Electronic Article

Year of Publication:

2019

Contained In:

Journal of gastroenterology and hepatology - Vol. 34, No. 6 (2019), p. 996-1003

Language:

English

Contributors:

Burisch, Johan
Zammit, Stefania Chetcuti
Ellul, Pierre
Turcan, Svetlana
Duricova, Dana
Bortlik, Martin
Andersen, Karina Winther
Andersen, Vibeke
Kaimakliotis, Ioannis P
Fumery, Mathurin
Gower-Rousseau, Corinne
Girardin, Giulia
Valpiani, Daniela
Goldis, Adrian
Brinar, Marko
Čuković-Čavka, Silvija
Oksanen, Pia
Collin, Pekka
Barros, Luisa
Magro, Fernando
Misra, Ravi
Arebi, Naila
Eriksson, Carl
Halfvarson, Jonas
Kievit, Hendrika Adriana Linda
Pedersen, Natalia
Kjeldsen, Jens
Myers, Sally
Sebastian, Shaji
Katsanos, Konstantinos H
Christodoulou, Dimitrios K
Midjord, Jóngerð
Nielsen, Kári Rubek
Kiudelis, Gediminas
Kupcinskas, Limas
Nikulina, Inna
Belousova, Elena
Schwartz, Doron
Odes, Selwyn
Salupere, Riina
Carmona, Amalia
Pineda, Juan R
Vegh, Zsuzsanna
Lakatos, Peter L
Langholz, Ebbe
Munkholm, Pia
Epi-IBD group

Urls:

Volltext

Keywords:

4Q81I59GXC
Adult
Cohort Studies
Colectomy
Colitis, Ulcerative
Disease Progression
Europe
Female
Follow-Up Studies
Humans
Inflammatory Bowel Diseases
Inflammatory bowel disease unclassified
Journal Article
Male
Mesalamine
Middle Aged
Prognosis
Prospective Studies
Time Factors
Treatment

Notes:

Date Completed 06.12.2019

Date Revised 17.12.2019

published: Print-Electronic

Citation Status MEDLINE

Copyright: From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Physical Description:

Online-Ressource

doi:

10.1111/jgh.14563

PMID:

30562421

PPN (Catalogue-ID):

NLM292375956