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Course of disease in patients with microscopic colitis: a European prospective incident cohort study
Division of Gastroenterology-Hepatology, Maastricht University Medical Center, Maastricht, the Netherlands.
Department of Gastroenterology and Hepatology in Linköping and department of Health, Medicine, and Caring Sciences, Linköping University, Linköping, Sweden.
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.
Department of Gastroenterology, Zealand University Hospital, Køge, Denmark; Department of Clinical Medicine, University of Copenhagen, Denmark.
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2021 (English)In: Journal of Crohn's & Colitis, ISSN 1873-9946, E-ISSN 1876-4479, Vol. 15, no 7, p. 1174-1183, article id jjab007Article in journal (Refereed) Published
Abstract [en]

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 health care professionals on the expected course of the disease and real-life response to therapy are warranted.

METHODS: A prospective, pan-European, multi-center, 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 suffers a chronic active or relapsing disease course during the first year after diagnosis, with persisting symptoms accompanied by a significantly impaired quality of life.

Place, publisher, year, edition, pages
Oxford University Press, 2021. Vol. 15, no 7, p. 1174-1183, article id jjab007
Keywords [en]
Microscopic colitis, disease activity, disease course, prognosis, prospective cohort study, treatment
National Category
Gastroenterology and Hepatology
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URN: urn:nbn:se:oru:diva-88485DOI: 10.1093/ecco-jcc/jjab007ISI: 000733846400012PubMedID: 33433605Scopus ID: 2-s2.0-85104091819OAI: oai:DiVA.org:oru-88485DiVA, id: diva2:1517317
Available from: 2021-01-13 Created: 2021-01-13 Last updated: 2022-01-04Bibliographically approved

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