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欧洲炎症性肠病发病队列中的初始疾病过程和治疗:ECCO-EpiCom 队列。

Initial disease course and treatment in an inflammatory bowel disease inception cohort in Europe: the ECCO-EpiCom cohort.

机构信息

1Medical Section, Digestive Disease Centre, Medical Section, Herlev University Hospital, Copenhagen, Denmark; 2Division of Gastroenterology and Hepatology, University Hospital Center Zagreb, University of Zagreb School of Medicine, Zagreb, Croatia; 3Nicosia Private Practice, Nicosia, Cyprus; 4IBD Center ISCARE, Charles University, Prague, Czech Republic; 5Gastroenterology Department, Hospital České Budějovice, České Budějovice, Czech Republic; 6Department of Medicine, Amager Hospital, Amager, Denmark; 7Department of Medicine, Herning Central Hospital, Herning, Denmark; 8Medical Department, Viborg Regional Hospital, Viborg, Denmark; 9Medical Department, Hospital of Southern Jutland, Aabenraa, Denmark; 10Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark; 11Department of Medicine V (Hepatology and Gastroenterology), Aarhus University Hospital, Arhus, Denmark; 12Department of Medical Gastroenterology, Odense University Hospital, Odense, Denmark; 13Division of Endocrinology and Gastroenterology, Tartu University Hospital, Tartu, Estonia; 14Medical Department, The National Hospital of the Faroe Islands, Torshavn, Faroe Islands; 15Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Tampere, Finland; 161st Division of Internal Medicine and Hepato-Gastroenterology Unit, University Hospital, Ioannina, Greece; 17Medical Department, Dronning Ingrids Hospital, Nuuk, Greenland; 18Department of Medicine, Csolnoky F. Province Hospital, Veszprem, Hungary; 19Department of Gastroenterology, Adelaide and Meath Hospital, Trinity College of Dublin, Dublin, Ireland; 20Department of Gastroenterology and Hepatology, Soroka Medical Center and Ben Gurion University of the Negev, Beer Sheva, Israel; 21U.O. Gastroenterologia, Azienda Ospedaliera, Università di Padova, Padova, Italy; 22EpiCom Northern Italy Centre based in Crema & Cremona, Padova and Reggio Emilia, Italy; 23UO Medicina 3° e Gastroenterologia, Azie

出版信息

Inflamm Bowel Dis. 2014 Jan;20(1):36-46. doi: 10.1097/01.MIB.0000436277.13917.c4.

DOI:10.1097/01.MIB.0000436277.13917.c4
PMID:24252978
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.

摘要

背景

EpiCom 队列是一项前瞻性、基于人群、以炎症性肠病(IBD)患者为基础的队列研究,来自 31 个欧洲中心,涵盖了 1010 万背景人群。本研究的目的是评估 EpiCom 队列的 1 年结果。

方法

在最初的 12(±3)个月内,每三个月对患者进行一次随访,收集并输入临床数据、人口统计学、疾病活动、药物治疗、手术、癌症和死亡等数据,并录入一个基于网络的数据库(www.epicom-ecco.eu)。

结果

共有 1367 例患者完成了 1 年随访。在西欧,65 例克罗恩病(CD)(16%)、20 例溃疡性结肠炎(UC)(4%)和 4 例未分类 IBD(4%)患者接受了手术,而在东欧,12 例 CD(12%)和 2 例 UC(1%)患者接受了手术。81 例 CD(20%)、80 例 UC(14%)和 13 例未分类 IBD(9%)患者在西欧住院,而东欧有 17 例 CD(16%)和 12 例 UC(8%)患者住院。在西欧,CD 患者接受免疫调节剂治疗的累积概率为 57%(中位治疗时间为 2 个月),在东欧为 44%(1 个月),分别有 21%(5 个月)和 5%(6 个月)接受生物治疗。对于 UC 患者,在西欧,免疫调节剂的累积概率分别为 22%(4 个月)和 15%(3 个月),生物治疗分别为 6%(3 个月)和 1%(12 个月),在东欧,免疫调节剂的累积概率分别为 22%(4 个月)和 15%(3 个月),生物治疗分别为 6%(3 个月)和 1%(12 个月)。

讨论

在本队列中,免疫治疗在疾病的最初几个月内开始。东欧和西欧的患者手术和住院率没有差异,尽管更多的西欧患者接受了生物制剂,与以前的基于人群的起始队列相当。

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