ArticleThe American journal of gastroenterology2017
Improvements in the Long-Term Outcome of Crohn's Disease Over the Past Two Decades and the Relation to Changes in Medical Management: Results from the Population-Based IBDSL Cohort.
Article in The American journal of gastroenterology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 78 papers, 6 of them syntheses that pooled it.
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Who cites it
78 citing papers in PubMed, 6 syntheses or guidelines pooled it.
- Comparative Efficacy and Safety of Advanced Therapies in Maintenance Treatment of Adult Patients with Moderate-to-Severe Crohn's Disease: A Systematic Literature Review and Network Meta-Analysis.Advances in therapy · 2026Pooled it
- Systematic review: societal cost of illness of inflammatory bowel disease is increasing due to biologics and varies between continents.Alimentary pharmacology & therapeutics · 2021Pooled it
- Prognostic biomarkers to identify patients likely to develop severe Crohn's disease: a systematic review.Health technology assessment (Winchester, England) · 2021Pooled it
- AGA Clinical Practice Guidelines on the Medical Management of Moderate to Severe Luminal and Perianal Fistulizing Crohn's Disease.Gastroenterology · 2021Guideline
- WSES-AAST guidelines: management of inflammatory bowel disease in the emergency setting.World journal of emergency surgery : WJES · 2021Guideline
- Patient sex does not affect endoscopic outcomes of biologicals in inflammatory bowel disease but is associated with adverse events.International journal of colorectal disease · 2020Pooled it
- Proactive Tight Monitoring of Patients with Inflammatory Bowel Disease in Biological Therapy: A Controlled Clinical Study (TIME IT).Journal of clinical medicine · 2026Article
- More severe natural course of Crohn's disease in Yunnan province compared with Asian and Western countries.International journal of colorectal disease · 2026Article
- The exosomal miR-26b-3p derived from Crohn's disease-associated mesenteric adipose tissue induces M1 macrophage polarization and exacerbates ileocolonic anastomosis inflammation via the p38-MAPK signaling pathway.Frontiers in immunology · 2026Article
- Article
- Beyond inflammation: what drives the self-perpetuating cycle of fibrosis in IBD?Annals of medicine · 2025Review
- Methotrexate in the management of Crohn's disease: A practice survey of gastroenterologists in France.World journal of gastroenterology · 2025Article
- Temporal trends in surgical treatment of inflammatory bowel disease following introduction of biological drugs in Norway and Sweden.BMJ open gastroenterology · 2025Article
- Changes in Medical Management of Inflammatory Bowel Disease and Reducing Surgical Risk: Investigating Causality Through the Bradford-Hill Criteria.Journal of clinical medicine · 2025Review
- Nationwide study on clinical impact of early tumor necrosis factor-α inhibitors following first intestinal resection in biologics-naïve Crohn's disease patients.Scientific reports · 2025Article
- Prevalence, incidence, and mortality of inflammatory bowel disease in the Netherlands: development and external validation of machine learning models.Journal of Crohn's & colitis · 2025Article
- Crohn's Disease Phenotypes and Associations With Comorbidities, Surgery Risk, Medications and Nonmedication Approaches: The MAGIC in IMAGINE Study.Inflammatory bowel diseases · 2025Observational
- Challenges in the Management of Inflammatory Bowel Disease in Children: A Narrative Review.Clinical and experimental gastroenterology · 2025Review
- The Disease Severity Index for Inflammatory Bowel Disease Is a Valid Instrument that Predicts Complicated Disease.Inflammatory bowel diseases · 2024Article
- Progression of Crohn's Disease in Newly Diagnosed Patients: Results from an Observational Study Using US Claims Data.Digestive diseases and sciences · 2024Observational
18 more citing papers are in PubMed but not listed here.
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesMedical treatment options and strategies for Crohn's disease (CD) have changed over the past decades. To assess its impact, we studied the evolution of the long-term disease outcome in the Dutch Inflammatory Bowel Disease South Limburg (IBDSL) cohort.
methodsIn total, 1,162 CD patients were included. Three eras were distinguished: 1991-1998 (n=316), 1999-2005 (n=387), and 2006-2011 (n=459), and patients were followed until 2014. Medication exposure and the rates of hospitalization, surgery, and phenotype progression were estimated using Kaplan-Meier survival analyses and compared between eras by multivariable Cox regression models. Second, propensity score matching was used to assess the relation between medication use and the long-term outcome.
resultsOver time, the immunomodulator exposure rate increased from 30.6% in the era 1991-1998 to 70.8% in the era 2006-2011 at 5 years. Similar, biological exposure increased from 3.1% (era 1991-1998) to 41.2% (era 2006-2011). In parallel, the hospitalization rate attenuated from 65.9% to 44.2% and the surgery rate from 42.9% to 17.4% at 5 years, respectively (both P<0.01). Progression to a complicated phenotype has not changed over time (21.2% in the era 1991-1998 vs. 21.3% in the era 2006-2011, P=0.93). Immunomodulator users had a similar risk of hospitalization, surgery, or phenotype progression as propensity score-matched nonusers (P>0.05 for all analyses). Similar results were found for biological users (P>0.05 for all analyses).
conclusionsBetween 1991 and 2014, the hospitalization and surgery rates decreased, whereas progression to complicated disease is still common in CD. These improvements were not significantly related to the use of immunomodulators and biologicals.
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