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Inflammatory Bowel Diseases:
doi: 10.1097/01.MIB.0000436277.13917.c4
Original Clinical Articles

Initial Disease Course and Treatment in an Inflammatory Bowel Disease Inception Cohort in Europe: The ECCO-EpiCom Cohort

Burisch, Johan MD1; Pedersen, Natalia MD1; Cukovic-Cavka, Silvja MD2; Turk, Niksa MD2; Kaimakliotis, Ioannis MD3; Duricova, Dana PhD4; Shonová, Olga MD5; Vind, Ida PhD6; Avnstrøm, Søren DMSc6; Thorsgaard, Niels DMSc7; Krabbe, Susanne8; Andersen, Vibeke PhD8,9,10; Dahlerup Jens, Frederik DMSc11; Kjeldsen, Jens PhD12; Salupere, Riina MD13; Olsen, Jóngerð14; Nielsen, Kári Rubek MD14; Manninen, Pia MD15; Collin, Pekka MD15; Katsanos, Konstantinnos H. MD16; Tsianos, Epameinondas V. PhD16; Ladefoged, Karin DMSc17; Lakatos, Laszlo MD18; Bailey, Yvonne19; O’Morain, Colm MD19; Schwartz, Doron MD20; Odes, Selwyn MD20; Martinato, Matteo21,22; Lombardini, Silvia MD22,23; Jonaitis, Laimas MD24; Kupcinskas, Limas MD25; Turcan, Svetlana MD25; Barros, Louisa MD26; Magro, Fernando MD27,28,29; Lazar, Daniela MD30; Goldis, Adrian MD30; Nikulina, Inna MD31; Belousova, Elena MD31; Fernandez, Alberto MD32; Hernandez, Vicent MD33; Almer, Sven PhD34,35; Zhulina, Yaroslava MD36; Halfvarson, Jonas PhD36,37; Tsai, Her-Hsin MD38; Sebastian, Shaji MD38; Lakatos, Peter Laszlo PhD39; Langholz, Ebbe DMSc40; Munkholm, Pia DMSc1

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Abstract

Background:

The EpiCom cohort is a prospective, population-based, inception cohort of inflammatory bowel disease (IBD) patients from 31 European centers covering a background population of 10.1 million. The aim of this study was to assess the 1-year outcome in the EpiCom cohort.

Methods:

Patients were followed-up every third month during the first 12 (±3) months, and clinical data, demographics, disease activity, medical therapy, surgery, cancers, and deaths were collected and entered in a Web-based database ( www.epicom-ecco.eu).

Results:

In total, 1367 patients were included in the 1-year follow-up. In western Europe, 65 Crohn’s disease (CD) (16%), 20 ulcerative colitis (UC) (4%), and 4 IBD unclassified (4%) patients underwent surgery, and in eastern Europe, 12 CD (12%) and 2 UC (1%) patients underwent surgery. Eighty-one CD (20%), 80 UC (14%), and 13 (9%) IBD unclassified patients were hospitalized in western Europe compared with 17 CD (16%) and 12 UC (8%) patients in eastern Europe. The cumulative probability of receiving immunomodulators was 57% for CD in western (median time to treatment 2 months) and 44% (1 month) in eastern Europe, and 21% (5 months) and 5% (6 months) for biological therapy, respectively. For UC patients, the cumulative probability was 22% (4 months) and 15% (3 months) for immunomodulators and 6% (3 months) and 1% (12 months) for biological therapy, respectively in the western and eastern Europe.

Discussion:

In this cohort, immunological therapy was initiated within the first months of disease. Surgery and hospitalization rates did not differ between patients from eastern and western Europe, although more western European patients received biological agents and were comparable to previous population-based inception cohorts.

Copyright © 2013 Crohn's & Colitis Foundation of America, Inc.

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