TY - JOUR

T1 - Course of Disease in Patients with Microscopic Colitis

T2 - A European Prospective Incident Cohort Study

AU - Verhaegh, Bas P.M.

AU - Münch, Andreas

AU - Guagnozzi, Danila

AU - Wildt, Signe

AU - Cebula, Wojciech

AU - Diac, Andreea R.

AU - Fernández-Bañares, Fernando

AU - Al-Khalaf, Magid A.R.

AU - Pedersen, Natalia

AU - Kupcinskas, Juozas

AU - Bohr, Johan

AU - Macaigne, Gilles

AU - Lucendo, Alfredo J.

AU - Lyutakov, Ivan

AU - Tontini, Gian Eugenio

AU - Pigò, Flavia

AU - Russo, Evangelos

AU - Hjortswang, Henrik

AU - Miehlke, Stephan

AU - Munck, Lars K.

N1 - Publisher Copyright: © The Author(s) 2021. Published by Oxford University Press on behalf of European Crohn’s and Colitis Organisation. All rights reserved. For permissions, please email: journals.permissions@oup.com.

PY - 2021

Y1 - 2021

N2 - 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.

AB - 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.

KW - disease activity

KW - disease course

KW - Microscopic colitis

KW - prognosis

KW - prospective cohort study

KW - treatment

U2 - 10.1093/ecco-jcc/jjab007

DO - 10.1093/ecco-jcc/jjab007

M3 - Journal article

C2 - 33433605

AN - SCOPUS:85104091819

VL - 15

SP - 1174

EP - 1183

JO - Journal of Crohn's and Colitis

JF - Journal of Crohn's and Colitis

SN - 1873-9946

IS - 7

ER -