TY - JOUR
T1 - Disease course of inflammatory bowel disease unclassified in a European population-based inception cohort
T2 - An Epi-IBD study
AU - for the Epi-IBD group
AU - Burisch, Johan
AU - Zammit, Stefania Chetcuti
AU - Ellul, Pierre
AU - Turcan, Svetlana
AU - Duricova, Dana
AU - Bortlik, Martin
AU - Andersen, Karina Winther
AU - Andersen, Vibeke
AU - Kaimakliotis, Ioannis P.
AU - Fumery, Mathurin
AU - Gower-Rousseau, Corinne
AU - Girardin, Giulia
AU - Valpiani, Daniela
AU - Goldis, Adrian
AU - Brinar, Marko
AU - Čuković-Čavka, Silvija
AU - Oksanen, Pia
AU - Collin, Pekka
AU - Barros, Luisa
AU - Magro, Fernando
AU - Misra, Ravi
AU - Arebi, Naila
AU - Eriksson, Carl
AU - Halfvarson, Jonas
AU - Kievit, Hendrika Adriana Linda
AU - Pedersen, Natalia
AU - Kjeldsen, Jens
AU - Myers, Sally
AU - Sebastian, Shaji
AU - Katsanos, Konstantinos H.
AU - Christodoulou, Dimitrios K.
AU - Midjord, Jóngerð
AU - Nielsen, Kári Rubek
AU - Kiudelis, Gediminas
AU - Kupcinskas, Limas
AU - Nikulina, Inna
AU - Belousova, Elena
AU - Schwartz, Doron
AU - Odes, Selwyn
AU - Salupere, Riina
AU - Carmona, Amalia
AU - Pineda, Juan R.
AU - Vegh, Zsuzsanna
AU - Lakatos, Peter L.
AU - Langholz, Ebbe
AU - Munkholm, Pia
N1 - Funding Information:
Abbvie A/S, Pfizer, MSD, and Takeda Pharma A/S; and unrestricted grant support from Takeda Pharma A/S. V Andersen: consultancy and advisory board member for Janssen and MSD. R Salupere: consulting fees and/or lecture fees from AbbVie, MSD, Takeda, and Janssen-Cilag. M Fumery: speaker/lecture fees for Abbvie, Ferring, MSD, Takeda, Boehringer, and Hospira. C Gower-Rousseau: lecture fees from Takeda, MSD, Ferring, and Tillotts. C Eriksson: lecture fees from Takeda. J Halfvarson: research grants from Janssen, MSD, and Takeda and lecture and/or consultancy fees from Abbvie, Celgene, Ferring, Hospira, Janssen, Medivir, MSD, Pfizer, Vifor Pharma, Takeda, and Tillotts Pharma. E Langholz: lecture or consultancy fees from MSD, Abbvie, and Ferring Pharmaceuticals. D Duricova: lecture or consultancy fees from AbbVie, Takeda, and Janssen. N Arebi: lecture fees from MSD and Jansen. Silvija Čuković-Čavka: lecture fees from Takeda, MSD, and Abbvie. P Oksanen: lecture or consultancy fees Janssen, Takeda, and Tillotts. F Magro: fee for presenting from AbbVie, Ferring, Falk, Hospira, PharmaKern, MSD, Schering, Lab. Vitoria, Vifor, and OmPharma. S Sebastian: research grants
Funding Information:
from Takeda, Abbvie, Tillotts Pharma, and Ferring and speaker fees and advisory board fees from Takeda, Jaansen, AbbVie, MSD, Ferring, Pharmacocosmos, and Tillotts. PL Lakatos: speaker and/or advisory board member for AbbVie, EGIS, Falk Pharma GmbH, Ferring, Genetech, Jansen, Kyowa Hakko Kirin Pharma, Mitsubishi Tanabe Pharma Corporation, MSD, Otsuka Pharma, Pharmacosmos, Pfizer, Roche, Shire, and Takeda and has received unrestricted research grant from AbbVie, MSD, and Pfizer. All other authors report no conflicts of interest. Author contribution: All authors contributed to the study design, acquisition of data, interpretation of data, and critical revision of the manuscript for important intellectual content. Johan Burisch contributed to the study concept and design, acquisition of data, analysis and interpretation of data, drafting of the manuscript, and statistical analysis and obtained funding. Pia Munkholm contributed to the study concept and design, analysis and interpretation of data, critical revision of the manuscript for important intellectual content, and study supervision. Johan Burisch had full access to the data in the study and takes full responsibility for its veracity and statistical analysis. All authors approved the final version of the article, including the authorship list. Financial support: This work was supported by an unrestricted grant from Kirsten og Freddy Johansens Fond and from Nordsjællands Hospital Forskningsråd. The study sponsors have made no contributions to the study design, analysis, data interpretation, or publication. Guarantor of the article: Dr Johan Burisch
Publisher Copyright:
© 2018 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd
PY - 2019/6/1
Y1 - 2019/6/1
N2 - 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.
AB - 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.
KW - inflammatory bowel disease unclassified
KW - prognosis
KW - treatment
UR - http://www.scopus.com/inward/record.url?scp=85060325984&partnerID=8YFLogxK
U2 - 10.1111/jgh.14563
DO - 10.1111/jgh.14563
M3 - Article
C2 - 30562421
AN - SCOPUS:85060325984
SN - 0815-9319
VL - 34
SP - 996
EP - 1003
JO - Journal of Gastroenterology and Hepatology (Australia)
JF - Journal of Gastroenterology and Hepatology (Australia)
IS - 6
ER -