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Disease course of inflammatory bowel disease unclassified in a European population‐based inception cohort: An Epi‐IBD study
Author(s) -
Burisch Johan,
Zammit Stefania Chetcuti,
Ellul Pierre,
Turcan Svetlana,
Duricova Dana,
Bortlik Martin,
Andersen Karina Winther,
Andersen Vibeke,
Kaimakliotis Ioannis P,
Fumery Mathurin,
GowerRousseau Corinne,
Girardin Giulia,
Valpiani Daniela,
Goldis Adrian,
Brinar Marko,
ČukovićČavka Silvija,
Oksanen Pia,
Collin Pekka,
Barros Luisa,
Magro Fernando,
Misra Ravi,
Arebi Naila,
Eriksson Carl,
Halfvarson Jonas,
Kievit Hendrika Adriana Linda,
Pedersen Natalia,
Kjeldsen Jens,
Myers Sally,
Sebastian Shaji,
Katsanos Konstantinos H,
Christodoulou Dimitrios K,
Midjord Jóngerð,
Nielsen Kári Rubek,
Kiudelis Gediminas,
Kupcinskas Limas,
Nikulina Inna,
Belousova Elena,
Schwartz Doron,
Odes Selwyn,
Salupere Riina,
Carmona Amalia,
Pineda Juan R,
Vegh Zsuzsanna,
Lakatos Peter L,
Langholz Ebbe,
Munkholm Pia
Publication year - 2019
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.14563
Subject(s) - medicine , ulcerative colitis , inflammatory bowel disease , interquartile range , pancolitis , cohort , population , gastroenterology , prospective cohort study , crohn's disease , surgery , disease , colonoscopy , colorectal cancer , environmental health , cancer
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.