Natural disease course of Crohn's disease during the first 5 years after diagnosis in a European population-based inception cohort: an Epi-IBD study

Natural disease course of Crohn's disease during the first 5 years after diagnosis in a European population-based inception cohort: an Epi-IBD study
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DOI：
10.1136/gutjnl-2017-315568
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发表时间：
2019-03-01
期刊：
GUT
影响因子：
24.5
通讯作者：
Valantiene, Irena
Valantiene, Irena
中科院分区：
医学1区
文献类型：
--
作者：
Burisch, Johan;Kiudelis, Gediminas;Valantiene, Irena

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Epi-IBD队列是一个前瞻性的基于人群的初始队列，来自29个欧洲中心的炎症性肠病患者，覆盖近1000万人的背景人群。本研究的目的是评估克罗恩病（CD）患者的5年预后和病程。设计患者从诊断时起进行前瞻性随访，包括收集他们的临床资料、人口统计学资料、疾病活动、药物治疗、手术、癌症和死亡。结果共纳入488例患者，均获得随访，随访期间均未发生严重并发症。随访期间，107例（22%）患者接受手术，176例（36%）患者因CD住院。共有49例（14%）诊断为非狭窄、非穿透性疾病的患者进展为狭窄和/或穿透性疾病。西欧和东欧患者的这些发生率没有差异。然而，在治疗方面存在显著的地理差异：西欧接受生物治疗（33%）和免疫调节剂（66%）的患者多于东欧（分别为14%和54%，P
Objective The Epi-IBD cohort is a prospective population-based inception cohort of unselected patients with inflammatory bowel disease from 29 European centres covering a background population of almost 10 million people. The aim of this study was to assess the 5-year outcome and disease course of patients with Crohn's disease (CD).Design Patients were followed up prospectively from the time of diagnosis, including collection of their clinical data, demographics, disease activity, medical therapy, surgery, cancers and deaths. Associations between outcomes and multiple covariates were analysed by Cox regression analysis.Results In total, 488 patients were included in the study. During follow-up, 107 (22%) patients received surgery, while 176 (36%) patients were hospitalised because of CD. A total of 49 (14%) patients diagnosed with non-stricturing, non-penetrating disease progressed to either stricturing and/or penetrating disease. These rates did not differ between patients from Western and Eastern Europe. However, significant geographic differences were noted regarding treatment: more patients in Western Europe received biological therapy (33%) and immunomodulators (66%) than did those in Eastern Europe (14% and 54%, respectively, P