Natural History of Adult Ulcerative Colitis ...
Document type :
Article dans une revue scientifique: Article de synthèse/Review paper
PMID :
ArXiv :
hal-03552408
Permalink :
Title :
Natural History of Adult Ulcerative Colitis in Population-based Cohorts: A Systematic Review
Author(s) :
Fumery, Mathurin [Auteur]
Lille Inflammation Research International Center - U 995 [LIRIC]
Singh, Siddharth [Auteur]
Dulai Parambir, S [Auteur]
Gower, Corinne [Auteur]
Lille Inflammation Research International Center - U 995 [LIRIC]
Peyrin-Biroulet, Laurent [Auteur]
Sandborn William, J [Auteur]
Lille Inflammation Research International Center - U 995 [LIRIC]
Singh, Siddharth [Auteur]
Dulai Parambir, S [Auteur]
Gower, Corinne [Auteur]
Lille Inflammation Research International Center - U 995 [LIRIC]
Peyrin-Biroulet, Laurent [Auteur]
Sandborn William, J [Auteur]
Journal title :
Clinical Gastroenterology and Hepatology
Abbreviated title :
Clin. Gastroenterol. Hepatol.
Volume number :
16
Pages :
343-356.e3
Publication date :
2018-03
ISSN :
1542-3565
Keyword(s) :
Natural History
Population-based
Ulcerative Colitis
Population-based
Ulcerative Colitis
HAL domain(s) :
Sciences du Vivant [q-bio]
English abstract : [en]
Background & Aims
A comprehensive knowledge of the natural history of ulcerative colitis (UC) helps understand disease evolution, identify poor prognostic markers and impact of treatment strategies, and facilitates shared ...
Show more >Background & Aims A comprehensive knowledge of the natural history of ulcerative colitis (UC) helps understand disease evolution, identify poor prognostic markers and impact of treatment strategies, and facilitates shared decision-making. We systematically reviewed the natural history of UC in adult population-based cohort studies with long-term follow-up. Methods Through a systematic literature review of MEDLINE through March 31, 2016, we identified 60 studies performed in 17 population-based inception cohorts reporting the long-term course and outcomes of adult-onset UC (n = 15,316 UC patients). Results Left-sided colitis is the most frequent location, and disease extension is observed in 10%–30% of patients. Majority of patients have a mild-moderate course, which is most active at diagnosis and then in varying periods of remission or mild activity; about 10%–15% of patients experience an aggressive course, and the cumulative risk of relapse is 70%–80% at 10 years. Almost 50% of patients require UC-related hospitalization, and 5-year risk of re-hospitalization is ∼50%. The 5-year and 10-year cumulative risk of colectomy is 10%–15%; achieving mucosal healing is associated with lower risk of colectomy. About 50% of patients receive corticosteroids, although this proportion has decreased over time, with a corresponding increase in the use of immunomodulators (20%) and anti–tumor necrosis factor (5%–10%). Although UC is not associated with an increased risk of mortality, it is associated with high morbidity and work disability, comparable to Crohn’s disease. Conclusions UC is a disabling condition over time. Prospective cohorts are needed to evaluate the impact of recent strategies of early use of disease-modifying therapies and treat-to-target approach with immunomodulators and biologics. Long-term studies from low-incidence areas are also needed.Show less >
Show more >Background & Aims A comprehensive knowledge of the natural history of ulcerative colitis (UC) helps understand disease evolution, identify poor prognostic markers and impact of treatment strategies, and facilitates shared decision-making. We systematically reviewed the natural history of UC in adult population-based cohort studies with long-term follow-up. Methods Through a systematic literature review of MEDLINE through March 31, 2016, we identified 60 studies performed in 17 population-based inception cohorts reporting the long-term course and outcomes of adult-onset UC (n = 15,316 UC patients). Results Left-sided colitis is the most frequent location, and disease extension is observed in 10%–30% of patients. Majority of patients have a mild-moderate course, which is most active at diagnosis and then in varying periods of remission or mild activity; about 10%–15% of patients experience an aggressive course, and the cumulative risk of relapse is 70%–80% at 10 years. Almost 50% of patients require UC-related hospitalization, and 5-year risk of re-hospitalization is ∼50%. The 5-year and 10-year cumulative risk of colectomy is 10%–15%; achieving mucosal healing is associated with lower risk of colectomy. About 50% of patients receive corticosteroids, although this proportion has decreased over time, with a corresponding increase in the use of immunomodulators (20%) and anti–tumor necrosis factor (5%–10%). Although UC is not associated with an increased risk of mortality, it is associated with high morbidity and work disability, comparable to Crohn’s disease. Conclusions UC is a disabling condition over time. Prospective cohorts are needed to evaluate the impact of recent strategies of early use of disease-modifying therapies and treat-to-target approach with immunomodulators and biologics. Long-term studies from low-incidence areas are also needed.Show less >
Language :
Anglais
Audience :
Internationale
Popular science :
Non
Administrative institution(s) :
Inserm
Université de Lille
CHU Lille
Université de Lille
CHU Lille
Research team(s) :
Inflammatory digestive disease : pathophysiology and therapeutic targets developement
IBD and environnemental factors : epidemiology and functional analyses
IBD and environnemental factors : epidemiology and functional analyses
Submission date :
2019-03-01T14:35:18Z
2024-03-08T08:58:17Z
2024-03-08T08:58:17Z