TY - JOUR
T1 - Disease course of inflammatory bowel disease unclassified in a European population-based inception cohort
T2 - An Epi-IBD study
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
AU - Epi-IBD group
PY - 2019
Y1 - 2019
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.
U2 - 10.1111/jgh.14563
DO - 10.1111/jgh.14563
M3 - Journal article
C2 - 30562421
VL - 34
SP - 996
EP - 1003
JO - Journal of Gastroenterology and Hepatology
JF - Journal of Gastroenterology and Hepatology
SN - 0815-9319
IS - 6
ER -