학술논문
Clinical predictors for a complicated course of disease in an inception cohort of patients with ulcerative colitis: results from the prospective, observational EPICOL study
Original Article
Original Article
Document Type
Clinical report
Author
Source
International Journal of Colorectal Disease. February 2022, Vol. 37 Issue 2, p485, 9 p.
Subject
Language
English
ISSN
0179-1958
Abstract
Author(s): Carsten Schmidt [sup.1] [sup.2], Bernd Bokemeyer [sup.3], Andreas Lügering [sup.4], Dominik Bettenworth [sup.5], Niels Teich [sup.2] [sup.6], Imma Fischer [sup.7], Leonie Hammer [sup.8], Stefanie Kolterer [sup.8], Stefan Rath [sup.8], [...]
Purpose The clinical course of ulcerative colitis (UC) is highly heterogeneous, with 20 to 30% of patients experiencing chronic disease activity requiring immunosuppressive or biologic therapies. The aim of this study was to identify predictors for a complicated disease course in an inception cohort of patients with UC. Methods EPICOL was a prospective, observational, inception cohort (UC diagnosis, [less than or equal to] 6 months) study in 311 patients with UC who were naive to immunosuppressants (IS)/biologics. A complicated course of disease was defined as the need for IS and/or biologic treatment (here therapy with a TNF-[alpha] antagonist) and/or UC-related hospitalisation. Patients were followed up for 24 months. Results Of the 307 out of 311 participants (4 patients did not meet the inclusion criteria 'confirmed diagnosis of active UC within the last 6 months' (n = 2) and 'immunosuppressive-naïve' (n = 2), analysis population), 209 (68.1%) versus 98 (31.9%) had an uncomplicated versus a complicated disease course, respectively. In a multivariate regression analysis, prior use of corticosteroids and prior anaemia were associated with a significantly increased risk for a complicated disease course (2.3- and 1.9-fold increase, respectively; p < 0.001 and p = 0.002). Based on these parameters, a risk model for patient stratification was developed. Conclusion Our study identifies anaemia and an early need for corticosteroids as predictors for a complicated course of disease in an inception cohort of patients with UC. By determining these parameters in routine clinical practice, our results may support the identification of patients who might benefit from early escalation of therapy.
Purpose The clinical course of ulcerative colitis (UC) is highly heterogeneous, with 20 to 30% of patients experiencing chronic disease activity requiring immunosuppressive or biologic therapies. The aim of this study was to identify predictors for a complicated disease course in an inception cohort of patients with UC. Methods EPICOL was a prospective, observational, inception cohort (UC diagnosis, [less than or equal to] 6 months) study in 311 patients with UC who were naive to immunosuppressants (IS)/biologics. A complicated course of disease was defined as the need for IS and/or biologic treatment (here therapy with a TNF-[alpha] antagonist) and/or UC-related hospitalisation. Patients were followed up for 24 months. Results Of the 307 out of 311 participants (4 patients did not meet the inclusion criteria 'confirmed diagnosis of active UC within the last 6 months' (n = 2) and 'immunosuppressive-naïve' (n = 2), analysis population), 209 (68.1%) versus 98 (31.9%) had an uncomplicated versus a complicated disease course, respectively. In a multivariate regression analysis, prior use of corticosteroids and prior anaemia were associated with a significantly increased risk for a complicated disease course (2.3- and 1.9-fold increase, respectively; p < 0.001 and p = 0.002). Based on these parameters, a risk model for patient stratification was developed. Conclusion Our study identifies anaemia and an early need for corticosteroids as predictors for a complicated course of disease in an inception cohort of patients with UC. By determining these parameters in routine clinical practice, our results may support the identification of patients who might benefit from early escalation of therapy.