Disease Course and Surgery Rates in Inflammatory Bowel Disease: A Population-Based, 7-Year Follow-Up Study in the Era of Immunomodulating Therapy

Marianne K Vester-Andersen; Michelle V Prosberg; Tine Jess; Mikael Andersson; Bo G Bengtsson; Thomas Blixt; Pia Munkholm; Flemming Bendtsen; Ida Vind

doi:10.1038/ajg.2014.45

Disease Course and Surgery Rates in Inflammatory Bowel Disease: A Population-Based, 7-Year Follow-Up Study in the Era of Immunomodulating Therapy

Marianne K Vester-Andersen, Michelle V Prosberg, Tine Jess, Mikael Andersson, Bo G Bengtsson, Thomas Blixt, Pia Munkholm, Flemming Bendtsen, Ida Vind

Department of Clinical Medicine

113 Citations (Scopus)

Abstract

OBJECTIVES: In this population-based 7-year follow-up of incident patients with ulcerative colitis (UC) or Crohn's disease (CD), we aimed to describe disease progression and surgery rates in an era influenced by the increased use of immunosuppressants and the introduction of biological therapy.

METHODS: From 1 January 2003 to 31 December 2004, all incident cases (562) of patients diagnosed with UC, CD, or inflammatory bowel disease unclassified in a well-defined Copenhagen area were registered. Medical records were reviewed from 1 November 2011 to 30 November 2012, and clinical data were registered. Clinical data on surgery, cancer, and death were cross-checked with register data from national health administrative databases in order to include missed data.

RESULTS: In total, 513 patients (213 CD and 300 UC) entered the follow-up study. Twenty-six patients changed diagnosis during the follow-up. Changes in disease localization and behavior in CD according to the Vienna classification were observed in 23.9% and 15.0% of the patients, respectively, during follow-up. In total, 28.3% of the 300 UC patients had disease progression during the follow-up. The overall use of systemic steroids, immunomodulators, and anti-tumor necrosis factor agents in CD was 86.4%, 64.3%, and 23.5%, respectively. The rate of first-time intestinal resection in CD was 29.1% (n=62), and the 7-year cumulative risk was 28.5%. The cumulative risk of colectomy in UC was 12.5% at 7 years.

CONCLUSIONS: UC and CD are dynamic diseases that progress in extent and behavior over time. The resection rate in CD and the colectomy rate in UC are still relatively high, although the rates seem to have decreased compared with historic data, which could be due to an increase in the use of immunomodulating therapy.

Original language	English
Journal	The American Journal of Gastroenterology
Volume	109
Issue number	5
Pages (from-to)	705-714
Number of pages	10
ISSN	0002-9270
DOIs	https://doi.org/10.1038/ajg.2014.45
Publication status	Published - May 2014

Keywords

Adolescent
Adult
Aged
Aged, 80 and over
Anti-Inflammatory Agents
Antibodies, Monoclonal
Antibodies, Monoclonal, Humanized
Child
Child, Preschool
Colectomy
Databases, Factual
Denmark
Disease Progression
Drug Therapy, Combination
Female
Follow-Up Studies
Humans
Immunosuppressive Agents
Infant
Inflammatory Bowel Diseases
Male
Middle Aged
Prospective Studies
Registries
Treatment Outcome
Young Adult

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1038/ajg.2014.45

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Vester-Andersen, M. K., Prosberg, M. V., Jess, T., Andersson, M., Bengtsson, B. G., Blixt, T., Munkholm, P., Bendtsen, F., & Vind, I. (2014). Disease Course and Surgery Rates in Inflammatory Bowel Disease: A Population-Based, 7-Year Follow-Up Study in the Era of Immunomodulating Therapy. The American Journal of Gastroenterology, 109(5), 705-714. https://doi.org/10.1038/ajg.2014.45

Disease Course and Surgery Rates in Inflammatory Bowel Disease : A Population-Based, 7-Year Follow-Up Study in the Era of Immunomodulating Therapy. / Vester-Andersen, Marianne K; Prosberg, Michelle V; Jess, Tine et al.

In: The American Journal of Gastroenterology, Vol. 109, No. 5, 05.2014, p. 705-714.

Research output: Contribution to journal › Journal article › Research › peer-review

Vester-Andersen, MK, Prosberg, MV, Jess, T, Andersson, M, Bengtsson, BG, Blixt, T, Munkholm, P, Bendtsen, F & Vind, I 2014, 'Disease Course and Surgery Rates in Inflammatory Bowel Disease: A Population-Based, 7-Year Follow-Up Study in the Era of Immunomodulating Therapy', The American Journal of Gastroenterology, vol. 109, no. 5, pp. 705-714. https://doi.org/10.1038/ajg.2014.45

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title = "Disease Course and Surgery Rates in Inflammatory Bowel Disease: A Population-Based, 7-Year Follow-Up Study in the Era of Immunomodulating Therapy",

abstract = "OBJECTIVES: In this population-based 7-year follow-up of incident patients with ulcerative colitis (UC) or Crohn's disease (CD), we aimed to describe disease progression and surgery rates in an era influenced by the increased use of immunosuppressants and the introduction of biological therapy.METHODS: From 1 January 2003 to 31 December 2004, all incident cases (562) of patients diagnosed with UC, CD, or inflammatory bowel disease unclassified in a well-defined Copenhagen area were registered. Medical records were reviewed from 1 November 2011 to 30 November 2012, and clinical data were registered. Clinical data on surgery, cancer, and death were cross-checked with register data from national health administrative databases in order to include missed data.RESULTS: In total, 513 patients (213 CD and 300 UC) entered the follow-up study. Twenty-six patients changed diagnosis during the follow-up. Changes in disease localization and behavior in CD according to the Vienna classification were observed in 23.9% and 15.0% of the patients, respectively, during follow-up. In total, 28.3% of the 300 UC patients had disease progression during the follow-up. The overall use of systemic steroids, immunomodulators, and anti-tumor necrosis factor agents in CD was 86.4%, 64.3%, and 23.5%, respectively. The rate of first-time intestinal resection in CD was 29.1% (n=62), and the 7-year cumulative risk was 28.5%. The cumulative risk of colectomy in UC was 12.5% at 7 years.CONCLUSIONS: UC and CD are dynamic diseases that progress in extent and behavior over time. The resection rate in CD and the colectomy rate in UC are still relatively high, although the rates seem to have decreased compared with historic data, which could be due to an increase in the use of immunomodulating therapy.",

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author = "Vester-Andersen, {Marianne K} and Prosberg, {Michelle V} and Tine Jess and Mikael Andersson and Bengtsson, {Bo G} and Thomas Blixt and Pia Munkholm and Flemming Bendtsen and Ida Vind",

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AU - Prosberg, Michelle V

AU - Jess, Tine

AU - Andersson, Mikael

AU - Bengtsson, Bo G

AU - Blixt, Thomas

AU - Munkholm, Pia

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N2 - OBJECTIVES: In this population-based 7-year follow-up of incident patients with ulcerative colitis (UC) or Crohn's disease (CD), we aimed to describe disease progression and surgery rates in an era influenced by the increased use of immunosuppressants and the introduction of biological therapy.METHODS: From 1 January 2003 to 31 December 2004, all incident cases (562) of patients diagnosed with UC, CD, or inflammatory bowel disease unclassified in a well-defined Copenhagen area were registered. Medical records were reviewed from 1 November 2011 to 30 November 2012, and clinical data were registered. Clinical data on surgery, cancer, and death were cross-checked with register data from national health administrative databases in order to include missed data.RESULTS: In total, 513 patients (213 CD and 300 UC) entered the follow-up study. Twenty-six patients changed diagnosis during the follow-up. Changes in disease localization and behavior in CD according to the Vienna classification were observed in 23.9% and 15.0% of the patients, respectively, during follow-up. In total, 28.3% of the 300 UC patients had disease progression during the follow-up. The overall use of systemic steroids, immunomodulators, and anti-tumor necrosis factor agents in CD was 86.4%, 64.3%, and 23.5%, respectively. The rate of first-time intestinal resection in CD was 29.1% (n=62), and the 7-year cumulative risk was 28.5%. The cumulative risk of colectomy in UC was 12.5% at 7 years.CONCLUSIONS: UC and CD are dynamic diseases that progress in extent and behavior over time. The resection rate in CD and the colectomy rate in UC are still relatively high, although the rates seem to have decreased compared with historic data, which could be due to an increase in the use of immunomodulating therapy.

AB - OBJECTIVES: In this population-based 7-year follow-up of incident patients with ulcerative colitis (UC) or Crohn's disease (CD), we aimed to describe disease progression and surgery rates in an era influenced by the increased use of immunosuppressants and the introduction of biological therapy.METHODS: From 1 January 2003 to 31 December 2004, all incident cases (562) of patients diagnosed with UC, CD, or inflammatory bowel disease unclassified in a well-defined Copenhagen area were registered. Medical records were reviewed from 1 November 2011 to 30 November 2012, and clinical data were registered. Clinical data on surgery, cancer, and death were cross-checked with register data from national health administrative databases in order to include missed data.RESULTS: In total, 513 patients (213 CD and 300 UC) entered the follow-up study. Twenty-six patients changed diagnosis during the follow-up. Changes in disease localization and behavior in CD according to the Vienna classification were observed in 23.9% and 15.0% of the patients, respectively, during follow-up. In total, 28.3% of the 300 UC patients had disease progression during the follow-up. The overall use of systemic steroids, immunomodulators, and anti-tumor necrosis factor agents in CD was 86.4%, 64.3%, and 23.5%, respectively. The rate of first-time intestinal resection in CD was 29.1% (n=62), and the 7-year cumulative risk was 28.5%. The cumulative risk of colectomy in UC was 12.5% at 7 years.CONCLUSIONS: UC and CD are dynamic diseases that progress in extent and behavior over time. The resection rate in CD and the colectomy rate in UC are still relatively high, although the rates seem to have decreased compared with historic data, which could be due to an increase in the use of immunomodulating therapy.

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JO - The American Journal of Gastroenterology

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ER -

Disease Course and Surgery Rates in Inflammatory Bowel Disease: A Population-Based, 7-Year Follow-Up Study in the Era of Immunomodulating Therapy

Abstract

Keywords

UN SDGs

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