Phenotype at diagnosis predicts recurrence rates in Crohn's disease

F L Wolters; M G Russel; J Sijbrandij; T Ambergen; S Odes; L Riis; E Langholz; P Politi; A Qasim; I Koutroubakis; E Tsianos; S Vermeire; J Freitas; G van Zeijl; O Hoie; T Bernklev; M Beltrami; D Rodriguez; R W Stockbrügger; B Moum

doi:10.1136/gut.2005.084061

Phenotype at diagnosis predicts recurrence rates in Crohn's disease

F L Wolters, M G Russel, J Sijbrandij, T Ambergen, S Odes, L Riis, E Langholz, P Politi, A Qasim, I Koutroubakis, E Tsianos, S Vermeire, J Freitas, G van Zeijl, O Hoie, T Bernklev, M Beltrami, D Rodriguez, R W Stockbrügger, B Moum

178 Citations (Scopus)

Abstract

BACKGROUND: In Crohn's disease (CD), studies associating phenotype at diagnosis and subsequent disease activity are important for patient counselling and health care planning.

AIMS: To calculate disease recurrence rates and to correlate these with phenotypic traits at diagnosis.

METHODS: A prospectively assembled uniformly diagnosed European population based inception cohort of CD patients was classified according to the Vienna classification for disease phenotype at diagnosis. Surgical and non-surgical recurrence rates throughout a 10 year follow up period were calculated. Multivariate analysis was performed to classify risk factors present at diagnosis for recurrent disease.

RESULTS: A total of 358 were classified for phenotype at diagnosis, of whom 262 (73.2%) had a first recurrence and 113 patients (31.6%) a first surgical recurrence during the first 10 years after diagnosis. Patients with upper gastrointestinal disease at diagnosis had an excess risk of recurrence (hazard ratio 1.54 (95% confidence interval (CI) 1.13-2.10)) whereas age >/=40 years at diagnosis was protective (hazard ratio 0.82 (95% CI 0.70-0.97)). Colonic disease was a protective characteristic for resective surgery (hazard ratio 0.38 (95% CI 0.21-0.69)). More frequent resective surgical recurrences were reported from Copenhagen (hazard ratio 3.23 (95% CI 1.32-7.89)).

CONCLUSIONS: A mild course of disease in terms of disease recurrence was observed in this European cohort. Phenotype at diagnosis had predictive value for disease recurrence with upper gastrointestinal disease being the most important positive predictor. A phenotypic North-South gradient in CD may be present, illustrated by higher surgery risks in some of the Northern European centres.

Original language	English
Journal	Gut
Volume	55
Issue number	8
Pages (from-to)	1124-30
Number of pages	7
ISSN	0017-5749
DOIs	https://doi.org/10.1136/gut.2005.084061
Publication status	Published - Aug 2006

Keywords

Adult
Age Factors
Crohn Disease/diagnosis
Epidemiologic Methods
Humans
Middle Aged
Phenotype
Prognosis
Recurrence

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10.1136/gut.2005.084061

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Wolters, F. L., Russel, M. G., Sijbrandij, J., Ambergen, T., Odes, S., Riis, L., Langholz, E., Politi, P., Qasim, A., Koutroubakis, I., Tsianos, E., Vermeire, S., Freitas, J., van Zeijl, G., Hoie, O., Bernklev, T., Beltrami, M., Rodriguez, D., Stockbrügger, R. W., & Moum, B. (2006). Phenotype at diagnosis predicts recurrence rates in Crohn's disease. Gut, 55(8), 1124-30. https://doi.org/10.1136/gut.2005.084061

Wolters, FL, Russel, MG, Sijbrandij, J, Ambergen, T, Odes, S, Riis, L, Langholz, E, Politi, P, Qasim, A, Koutroubakis, I, Tsianos, E, Vermeire, S, Freitas, J, van Zeijl, G, Hoie, O, Bernklev, T, Beltrami, M, Rodriguez, D, Stockbrügger, RW & Moum, B 2006, 'Phenotype at diagnosis predicts recurrence rates in Crohn's disease', Gut, vol. 55, no. 8, pp. 1124-30. https://doi.org/10.1136/gut.2005.084061

@article{ded2c42ea5c141c6abb1f848047f03ea,

title = "Phenotype at diagnosis predicts recurrence rates in Crohn's disease",

abstract = "BACKGROUND: In Crohn's disease (CD), studies associating phenotype at diagnosis and subsequent disease activity are important for patient counselling and health care planning.AIMS: To calculate disease recurrence rates and to correlate these with phenotypic traits at diagnosis.METHODS: A prospectively assembled uniformly diagnosed European population based inception cohort of CD patients was classified according to the Vienna classification for disease phenotype at diagnosis. Surgical and non-surgical recurrence rates throughout a 10 year follow up period were calculated. Multivariate analysis was performed to classify risk factors present at diagnosis for recurrent disease.RESULTS: A total of 358 were classified for phenotype at diagnosis, of whom 262 (73.2%) had a first recurrence and 113 patients (31.6%) a first surgical recurrence during the first 10 years after diagnosis. Patients with upper gastrointestinal disease at diagnosis had an excess risk of recurrence (hazard ratio 1.54 (95% confidence interval (CI) 1.13-2.10)) whereas age >/=40 years at diagnosis was protective (hazard ratio 0.82 (95% CI 0.70-0.97)). Colonic disease was a protective characteristic for resective surgery (hazard ratio 0.38 (95% CI 0.21-0.69)). More frequent resective surgical recurrences were reported from Copenhagen (hazard ratio 3.23 (95% CI 1.32-7.89)).CONCLUSIONS: A mild course of disease in terms of disease recurrence was observed in this European cohort. Phenotype at diagnosis had predictive value for disease recurrence with upper gastrointestinal disease being the most important positive predictor. A phenotypic North-South gradient in CD may be present, illustrated by higher surgery risks in some of the Northern European centres.",

keywords = "Adult, Age Factors, Crohn Disease/diagnosis, Epidemiologic Methods, Humans, Middle Aged, Phenotype, Prognosis, Recurrence",

author = "Wolters, {F L} and Russel, {M G} and J Sijbrandij and T Ambergen and S Odes and L Riis and E Langholz and P Politi and A Qasim and I Koutroubakis and E Tsianos and S Vermeire and J Freitas and {van Zeijl}, G and O Hoie and T Bernklev and M Beltrami and D Rodriguez and Stockbr{\"u}gger, {R W} and B Moum",

year = "2006",

month = aug,

doi = "10.1136/gut.2005.084061",

language = "English",

volume = "55",

pages = "1124--30",

journal = "Gut",

issn = "0017-5749",

publisher = "B M J Group",

number = "8",

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TY - JOUR

T1 - Phenotype at diagnosis predicts recurrence rates in Crohn's disease

AU - Wolters, F L

AU - Russel, M G

AU - Sijbrandij, J

AU - Ambergen, T

AU - Odes, S

AU - Riis, L

AU - Langholz, E

AU - Politi, P

AU - Qasim, A

AU - Koutroubakis, I

AU - Tsianos, E

AU - Vermeire, S

AU - Freitas, J

AU - van Zeijl, G

AU - Hoie, O

AU - Bernklev, T

AU - Beltrami, M

AU - Rodriguez, D

AU - Stockbrügger, R W

AU - Moum, B

PY - 2006/8

Y1 - 2006/8

N2 - BACKGROUND: In Crohn's disease (CD), studies associating phenotype at diagnosis and subsequent disease activity are important for patient counselling and health care planning.AIMS: To calculate disease recurrence rates and to correlate these with phenotypic traits at diagnosis.METHODS: A prospectively assembled uniformly diagnosed European population based inception cohort of CD patients was classified according to the Vienna classification for disease phenotype at diagnosis. Surgical and non-surgical recurrence rates throughout a 10 year follow up period were calculated. Multivariate analysis was performed to classify risk factors present at diagnosis for recurrent disease.RESULTS: A total of 358 were classified for phenotype at diagnosis, of whom 262 (73.2%) had a first recurrence and 113 patients (31.6%) a first surgical recurrence during the first 10 years after diagnosis. Patients with upper gastrointestinal disease at diagnosis had an excess risk of recurrence (hazard ratio 1.54 (95% confidence interval (CI) 1.13-2.10)) whereas age >/=40 years at diagnosis was protective (hazard ratio 0.82 (95% CI 0.70-0.97)). Colonic disease was a protective characteristic for resective surgery (hazard ratio 0.38 (95% CI 0.21-0.69)). More frequent resective surgical recurrences were reported from Copenhagen (hazard ratio 3.23 (95% CI 1.32-7.89)).CONCLUSIONS: A mild course of disease in terms of disease recurrence was observed in this European cohort. Phenotype at diagnosis had predictive value for disease recurrence with upper gastrointestinal disease being the most important positive predictor. A phenotypic North-South gradient in CD may be present, illustrated by higher surgery risks in some of the Northern European centres.

AB - BACKGROUND: In Crohn's disease (CD), studies associating phenotype at diagnosis and subsequent disease activity are important for patient counselling and health care planning.AIMS: To calculate disease recurrence rates and to correlate these with phenotypic traits at diagnosis.METHODS: A prospectively assembled uniformly diagnosed European population based inception cohort of CD patients was classified according to the Vienna classification for disease phenotype at diagnosis. Surgical and non-surgical recurrence rates throughout a 10 year follow up period were calculated. Multivariate analysis was performed to classify risk factors present at diagnosis for recurrent disease.RESULTS: A total of 358 were classified for phenotype at diagnosis, of whom 262 (73.2%) had a first recurrence and 113 patients (31.6%) a first surgical recurrence during the first 10 years after diagnosis. Patients with upper gastrointestinal disease at diagnosis had an excess risk of recurrence (hazard ratio 1.54 (95% confidence interval (CI) 1.13-2.10)) whereas age >/=40 years at diagnosis was protective (hazard ratio 0.82 (95% CI 0.70-0.97)). Colonic disease was a protective characteristic for resective surgery (hazard ratio 0.38 (95% CI 0.21-0.69)). More frequent resective surgical recurrences were reported from Copenhagen (hazard ratio 3.23 (95% CI 1.32-7.89)).CONCLUSIONS: A mild course of disease in terms of disease recurrence was observed in this European cohort. Phenotype at diagnosis had predictive value for disease recurrence with upper gastrointestinal disease being the most important positive predictor. A phenotypic North-South gradient in CD may be present, illustrated by higher surgery risks in some of the Northern European centres.

KW - Adult

KW - Age Factors

KW - Crohn Disease/diagnosis

KW - Epidemiologic Methods

KW - Humans

KW - Middle Aged

KW - Phenotype

KW - Prognosis

KW - Recurrence

U2 - 10.1136/gut.2005.084061

DO - 10.1136/gut.2005.084061

M3 - Journal article

C2 - 16361306

SN - 0017-5749

VL - 55

SP - 1124

EP - 1130

JO - Gut

JF - Gut

IS - 8

ER -

Phenotype at diagnosis predicts recurrence rates in Crohn's disease

Abstract

Keywords

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