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

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

doi:10.1111/jgh.14563

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

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

Department of Clinical Medicine

6 Citations (Scopus)

Abstract

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.

Original language	English
Journal	Journal of Gastroenterology and Hepatology
ISSN	0815-9319
DOIs	https://doi.org/10.1111/jgh.14563
Publication status	Published - Jun 2019

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Burisch, J., Zammit, S. C., Ellul, P., Turcan, S., Duricova, D., Bortlik, M., Andersen, K. W., Andersen, V., Kaimakliotis, I. P., Fumery, M., Gower-Rousseau, C., Girardin, G., Valpiani, D., Goldis, A., Brinar, M., Čuković-Čavka, S., Oksanen, P., Collin, P., Barros, L., ... Epi-IBD group (2019). Disease course of inflammatory bowel disease unclassified in a European population-based inception cohort: An Epi-IBD study. Journal of Gastroenterology and Hepatology. https://doi.org/10.1111/jgh.14563

Burisch, J, Zammit, SC, Ellul, P, Turcan, S, Duricova, D, Bortlik, M, Andersen, KW, Andersen, V, Kaimakliotis, IP, Fumery, M, Gower-Rousseau, C, Girardin, G, Valpiani, D, Goldis, A, Brinar, M, Čuković-Čavka, S, Oksanen, P, Collin, P, Barros, L, Magro, F, Misra, R, Arebi, N, Eriksson, C, Halfvarson, J, Kievit, HAL, Pedersen, N, Kjeldsen, J, Myers, S, Sebastian, S, Katsanos, KH, Christodoulou, DK, Midjord, J, Nielsen, KR, Kiudelis, G, Kupcinskas, L, Nikulina, I, Belousova, E, Schwartz, D, Odes, S, Salupere, R, Carmona, A, Pineda, JR, Vegh, Z, Lakatos, PL, Langholz, E , Munkholm, P & Epi-IBD group 2019, 'Disease course of inflammatory bowel disease unclassified in a European population-based inception cohort: An Epi-IBD study', Journal of Gastroenterology and Hepatology. https://doi.org/10.1111/jgh.14563

@article{b6c82ac1046b42f9b7912afa18c7f673,

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

abstract = "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.",

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

year = "2019",

month = jun,

doi = "10.1111/jgh.14563",

language = "English",

journal = "Journal of Gastroenterology and Hepatology",

issn = "0815-9319",

publisher = "Wiley-Blackwell Publishing Asia",

}

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 - 2019/6

Y1 - 2019/6

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

SN - 0815-9319

JO - Journal of Gastroenterology and Hepatology

JF - Journal of Gastroenterology and Hepatology

ER -

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

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