Journal
INFLAMMATORY BOWEL DISEASES
Volume 20, Issue 1, Pages 36-46Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/01.MIB.0000436277.13917.c4
Keywords
epidemiology; outcomes research; Crohn's disease; ulcerative colitis
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Funding
- Danish Colitis Crohn Patients Organization
- Vibeke Binder and Povl Riis' Foundation
- Scientific Council at the Herlev Hospital
- Sigrid Rigmor Moran Foundation
- Aage and Johanne Louis-Hansens Foundation
- Munkholm Foundation
- C.C. Klestrup and Henriette Klestrup Foundation
- Knud and Dagny Gad Andresens Foundation
- Else and Mogens Wedell-Wedellsborgs Foundation
- Direktor Jacob Madsen and Olga Madsens Foundation
- ScanVet
- Torben og Alice Frimodt Foundation
- Laegernes forsikringsforening
- Bengt Ihres Foundation
- Nanna Svartz Foundation
- Orebro University Hospital Research Foundation
- Orebro County Research Foundation
- Swedish Foundation for Gastrointestinal Research
- Swedish Research Council
- Swedish Society of Medicine
- Research Council of South-East Sweden
- County Council of Ostergotland
- Swedish Organization for the Study of Inflammatory Bowel Disease
- Competitive State Research Financing of the Expert Responsibility Area of Tampere University Hospital
- European Crohn's and Colitis Organization
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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.
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