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.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Burisch Johan, Kiudelis Gediminas, Kupcinskas Limas, Kievit Hendrika Adriana Linda, Andersen Karina Winther, Andersen Vibeke, Salupere Riina, Pedersen Natalia, Kjeldsen Jens, D'Incà Renata, Valpiani Daniela, Schwartz Doron, Odes Selwyn, Olsen Jóngerð, Nielsen Kári Rubek, Vegh Zsuzsanna, Lakatos Peter Laszlo, Toca Alina, Turcan Svetlana, Katsanos Konstantinos H, Christodoulou Dimitrios K, Fumery Mathurin, Gower-Rousseau Corinne, Zammit Stefania Chetcuti, Ellul Pierre, Eriksson Carl, Halfvarson Jonas, Magro Fernando Jose, Duricova Dana, Bortlik Martin, Fernandez Alberto, Hernández Vicent, Myers Sally, Sebastian Shaji, Oksanen Pia, Collin Pekka, Goldis Adrian, Misra Ravi, Arebi Naila, Kaimakliotis Ioannis P, Nikuina Inna, Belousova Elena, Brinar Marko, Cukovic-Cavka Silvija, Langholz Ebbe, Munkholm Pia, Epi-IBD group
Аннотация
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<0.01), while more Eastern European patients received 5-aminosalicylates (90% vs 56%, P<0.05). Treatment with immunomodulators reduced the risk of surgery (HR: 0.4, 95% CI 0.2 to 0.6) and hospitalisation (HR: 0.3, 95% CI 0.2 to 0.5).
CONCLUSION: Despite patients being treated early and frequently with immunomodulators and biological therapy in Western Europe, 5-year outcomes including surgery and phenotype progression in this cohort were comparable across Western and Eastern Europe. Differences in treatment strategies between Western and Eastern European centres did not affect the disease course. Treatment with immunomodulators reduced the risk of surgery and hospitalisation.