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Verhaegh BPM, Münch A, Guagnozzi D, Wildt S, Cebula W, Diac AR, Fernández-Bañares F, Al-Khalaf MAR, Pedersen N, Kupcinskas J, Bohr J, Macaigne G, Lucendo AJ, Lyutakov I, Tontini GE, Pigò F, Russo E, Hjortswang H, Miehlke S, Munck LK. Course of Disease in Patients with Microscopic Colitis: A European Prospective Incident Cohort Study. J Crohns Colitis 2021; 15:1174-1183. [PMID: 33433605 DOI: 10.1093/ecco-jcc/jjab007] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND AND AIMS The disease course of microscopic colitis [MC] is considered chronic but benign. However, this assumption is based on mainly retrospective studies, reporting on incomplete follow-up of selective cohorts. Systematic, prospective and unbiased data to inform patients and healthcare professionals on the expected course of the disease and real-life response to therapy are warranted. METHODS A prospective, pan-European, multi-centre, web-based registry was established. Incident cases of MC were included. Data on patient characteristics, symptoms, treatment and quality of life were systematically registered at baseline and during real-time follow-up. Four disease course phenotypes were discriminated and described. RESULTS Among 381 cases with complete 1-year follow-up, 49% had a chronic active or relapsing disease course, 40% achieved sustained remission after treatment and 11% had a quiescent course. In general, symptoms and quality of life improved after 3 months of follow-up. A relapsing or chronic active disease course was associated with significantly more symptoms and impaired quality of life after 1 year. CONCLUSIONS A minority of MC patients follow a quiescent disease course with spontaneous clinical improvement, whereas the majority suffer a chronic active or relapsing disease course during the first year after diagnosis, with persisting symptoms accompanied by a significantly impaired quality of life.
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Affiliation(s)
- Bas P M Verhaegh
- Division of Gastroenterology-Hepatology, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Andreas Münch
- Department of Gastroenterology and Hepatology in Linköping and Department of Health, Medicine, and Caring Sciences, Linköping University, Linköping, Sweden
| | - Danila Guagnozzi
- Neuro-Immuno-Gastroenterology Group, Digestive Physiology and Pathophysiology Unit, Vall d'Hebron Research Institute; Digestive System Department, Vall d'Hebron University Hostpital, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain
| | - Signe Wildt
- Department of Gastroenterology, Zealand University Hospital, Køge, Denmark.,Department of Clinical Medicine, University of Copenhagen, Denmark
| | - Wojciech Cebula
- Division of Gastroenterology, Department of Medicine, Nykoebing Falster Hospital, Nykoebing Falster, Denmark
| | - Andreea R Diac
- Division of Gastroenterology, Department of Medicine, Nykoebing Falster Hospital, Nykoebing Falster, Denmark
| | - Fernando Fernández-Bañares
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain.,Department of Gastroenterology, Hospital Universitari Mutua Terrassa, Terrassa, Spain
| | - Magid A R Al-Khalaf
- Division of Gastroenterology, Department of Medicine, Holbaek Hospital, Holbaek, Denmark
| | - Natalia Pedersen
- Department of Gastroenterology, Slagelse Hospital, Slagelse, Denmark
| | - Juozas Kupcinskas
- Department of Gastroenterology and Institute for Digestive Research, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Johan Bohr
- Division of Gastroenterology, Department of Medicine, Örebro University Hospital, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Gilles Macaigne
- Hepatogastroenterology Unit, Centre Hospitalier de Marne-la-Vallee, France
| | - Alfredo J Lucendo
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain.,Department of Gastroenterology, Hospital General de Tomelloso, Tomelloso, Spain.,Instituto de Investigación Sanitaria La Princesa, Madrid, Spain
| | - Ivan Lyutakov
- Department of Gastroenterology, Medical University of Sofia, University Hospital Tsaritsa Yoanna- ISUL, Sofia, Bulgaria
| | - Gian-Eugenio Tontini
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Gastroenterology and Endoscopy Unit, Department of Pathophysiology and Transplantation, University of Milan, Italy
| | - Flavia Pigò
- Gastroenterologia ed Endoscopia Digestiva, Ospedale Civile di Baggiovara, Modena, Italy
| | - Evangelos Russo
- Department of Gastroenterology, Imperial College Healthcare NHS Trust, London, UK
| | - Henrik Hjortswang
- Department of Gastroenterology and Hepatology in Linköping and Department of Health, Medicine, and Caring Sciences, Linköping University, Linköping, Sweden
| | - Stephan Miehlke
- Center for Digestive Diseases, Internal Medicine Center Eppendorf, Hamburg, Germany.,Center for Esophageal Disorders, University Hospital Eppendorf, Hamburg, Germany
| | - Lars K Munck
- Department of Gastroenterology, Zealand University Hospital, Køge, Denmark.,Department of Clinical Medicine, University of Copenhagen, Denmark
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