{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T00:28:36Z","timestamp":1788827316344,"version":"build-2803163510"},"reference-count":22,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2025,6,1]],"date-time":"2025-06-01T00:00:00Z","timestamp":1748736000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"EU Horizon Europe Program","award":["101095470"],"award-info":[{"award-number":["101095470"]}]},{"DOI":"10.13039\/100002491","name":"Bristol Meyers Squibb","doi-asserted-by":"crossref","award":["IM101-837"],"award-info":[{"award-number":["IM101-837"]}],"id":[{"id":"10.13039\/100002491","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,6,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background and aims<\/jats:title>\n                  <jats:p>The Epi-IBD cohort is a population-based inception cohort of patients with inflammatory bowel disease from 22 European centers. The aim was to assess the 10-year disease course of patients with ulcerative colitis (UC) across Europe.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Patients were followed prospectively from the time of diagnosis in 2010 and 2011, with a uniform collection of data to the end of 2020. Associations between covariates and colectomy, progression to extensive disease, and hospitalization were analyzed separately by multivariable Cox regression analyses in a propensity-score-matched subpopulation to address regional differences.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>A total of 873 UC patients were recruited (Eastern Europe: 196 [22.4%], Western Europe: 677 [77.5%]). The 10-year crude rate for the use of advanced therapy was comparable in Eastern (13%) and Western Europe (16%) (P\u2005&amp;gt;\u20050.9), and the median time from diagnosis until initiation of advanced treatment was similar, at 3 years. The need for colectomy remained comparable in Eastern and Western Europe, with a 10-year crude rate of 4% and 6% (Cox: P\u2005=\u20050.6), respectively. Likewise, disease progression to extensive disease (10-year rate: 17%, Cox: P\u2005=\u20050.06) and hospitalization (10-year rate: 23%, Cox: P\u2005=\u20050.2) were comparable across Europe. The use of advanced therapy and the early use of corticosteroids were both associated with an increased risk of colectomy (Cox: both P\u2005&amp;lt;\u20050.05).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>While the introduction of advanced therapies for UC has transformed the therapeutic landscape, their impact on colectomy rates, disease progression, and hospitalizations remains modest. Our findings highlight the need for continued innovation in UC treatment and the importance of individualized and targeted care to achieve optimal long-term outcomes.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ecco-jcc\/jjaf089","type":"journal-article","created":{"date-parts":[[2025,6,3]],"date-time":"2025-06-03T06:34:32Z","timestamp":1748932472000},"source":"Crossref","is-referenced-by-count":6,"title":["Long-term disease course of ulcerative colitis in a prospective European population-based inception cohort\u2014an Epi-IBD cohort study"],"prefix":"10.1093","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9140-9706","authenticated-orcid":false,"given":"Mads Damsgaard","family":"Wewer","sequence":"first","affiliation":[{"name":"Gastro Unit, Medical Division, University Hospital Copenhagen\u2014Amager and Hvidovre Hospital , Hvidovre,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S\u00f8ren","family":"Lophaven","sequence":"additional","affiliation":[{"name":"Omicron ApS , Copenhagen,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3948-6488","authenticated-orcid":false,"given":"Peter L","family":"Lakatos","sequence":"additional","affiliation":[{"name":"Department of Medicine and Oncology, Semmelweis University , Budapest,","place":["Hungary"]},{"name":"Division of Gastroenterology, McGill University , Montreal, Quebec,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorant","family":"Gonczi","sequence":"additional","affiliation":[{"name":"Department of Medicine and Oncology, Semmelweis University , Budapest,","place":["Hungary"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riina","family":"Salupere","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Tartu University Hospital, University of Tartu , Tartu,","place":["Estonia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hendrika Adriana Linda","family":"Kievit","sequence":"additional","affiliation":[{"name":"Department of Medicine, Regional Hospital G\u00f8dstrup , G\u00f8dstrup,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1028-644X","authenticated-orcid":false,"given":"K\u00e1ri Rubek","family":"Nielsen","sequence":"additional","affiliation":[{"name":"Medical Department, National Hospital of the Faroe Islands , Torshavn,","place":["Faroe Islands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00f3nger\u00f0","family":"Midjord","sequence":"additional","affiliation":[{"name":"Medical Department, National Hospital of the Faroe Islands , Torshavn,","place":["Faroe Islands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3715-5730","authenticated-orcid":false,"given":"Viktor","family":"Domislovic","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Hepatology and Nutrition, University Hospital Centre Zagreb , Zagreb,","place":["Croatia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u017deljko","family":"Krznari\u0107","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Hepatology and Nutrition, University Hospital Centre Zagreb , Zagreb,","place":["Croatia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalia","family":"Pedersen","sequence":"additional","affiliation":[{"name":"Gastroenterology Department, Slagelse Regional Hospital , Slagelse,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8148-6572","authenticated-orcid":false,"given":"Jens","family":"Kjeldsen","sequence":"additional","affiliation":[{"name":"Department of Medical Gastrointestinal Diseases, Odense University Hospital , Odense,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0122-7234","authenticated-orcid":false,"given":"Jonas","family":"Halfvarson","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Faculty of Medicine and Health, \u00d6rebro University , \u00d6rebro,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3670-6545","authenticated-orcid":false,"given":"Shaji","family":"Sebastian","sequence":"additional","affiliation":[{"name":"IBD Unit, Hull University Teaching Hospitals NHS Trust , Hull,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrian","family":"Goldis","sequence":"additional","affiliation":[{"name":"Clinic of Gastroenterology, University of Medicine \u2018Victor Babes\u2019 , Timisoara,","place":["Romania"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naila","family":"Arebi","sequence":"additional","affiliation":[{"name":"Department of Inflammatory Bowel Disease, St Mark\u2019s National Bowel Hospital , London,","place":["United Kingdom"]},{"name":"Department of Metabolism, Digestion and Reproduction, Imperial College London , London,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pia","family":"Oksanen","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital , Tampere,","place":["Finland"]},{"name":"Faculty of Medicine and Health Technology, Tampere University , Tampere,","place":["Finland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anders","family":"Neumann","sequence":"additional","affiliation":[{"name":"Medical Diagnostic Centre, Viborg Regional Hospital , Viborg,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0127-2863","authenticated-orcid":false,"given":"Vibeke","family":"Andersen","sequence":"additional","affiliation":[{"name":"Research Unit of Molecular Diagnostics and Clinical Research, Institute of Regional Health Research, University Hospital of Southern Denmark , Aabenraa,","place":["Denmark"]},{"name":"Institute of Regional Research, University of Southern Denmark , Odense,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konstantinos H","family":"Katsanos","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, University Hospital and University of Ioannina , Ioannina,","place":["Greece"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anastasios","family":"Koukoudis","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, University Hospital and University of Ioannina , Ioannina,","place":["Greece"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Svetlana","family":"Turcan","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Nicolae Testemitanu State University of Medicine and Pharmacy of Moldova , Chisinau,","place":["Moldova"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre","family":"Ellul","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Mater Dei Hospital , Msida,","place":["Malta"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juozas","family":"Kupcinskas","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Lithuanian University of Health Sciences , Kaunas,","place":["Lithuania"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gediminas","family":"Kiudelis","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Lithuanian University of Health Sciences , Kaunas,","place":["Lithuania"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2337-2902","authenticated-orcid":false,"given":"Mathurin","family":"Fumery","sequence":"additional","affiliation":[{"name":"Gastroenterology Unit, Amiens University Hospital , Amiens,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ioannis P","family":"Kaimakliotis","sequence":"additional","affiliation":[{"name":"American Gastroenterology Center , Nicosia,","place":["Cyprus"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renata","family":"D\u2019Inca","sequence":"additional","affiliation":[{"name":"Department of Surgical, Oncological and Gastroenterological Sciences, University of Padua , Padova,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Lombardini","sequence":"additional","affiliation":[{"name":"Medicine and Gastroenterology Unit, IBD Center, Internal Medicine Department, Azienda Unit\u00e0 Sanitaria Locale\u2014IRCCS , Reggio Emilia,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vicent","family":"Hernandez","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Complexo Hospitalario Universitario de Vigo (CHUVI), SERGAS , Vigo,","place":["Spain"]},{"name":"Research Group in Digestive Diseases, Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO , Vigo,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Fernandez","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Ribera-POVISA Hospital , Vigo,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8558-8442","authenticated-orcid":false,"given":"Ebbe","family":"Langholz","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, University Hospital Copenhagen\u2014Herlev Hospital , Herlev,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pia","family":"Munkholm","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, University Hospital Copenhagen\u2014North Zealand Hospital , Hiller\u00f8d,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johan","family":"Burisch","sequence":"additional","affiliation":[{"name":"Gastro Unit, Medical Division, University Hospital Copenhagen\u2014Amager and Hvidovre Hospital , Hvidovre,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,6,3]]},"reference":[{"key":"2025063009413877400_CIT0001","doi-asserted-by":"crossref","first-page":"1756","DOI":"10.1016\/S0140-6736(16)32126-2","article-title":"Ulcerative colitis","volume":"389","author":"Ungaro","year":"2017","journal-title":"Lancet (Lond)."},{"key":"2025063009413877400_CIT0002","doi-asserted-by":"crossref","first-page":"571","DOI":"10.1016\/S0140-6736(23)00966-2","article-title":"Ulcerative colitis","volume":"402","author":"Le Berre","year":"2023","journal-title":"Lancet (Lond)."},{"key":"2025063009413877400_CIT0003","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1053\/j.gastro.2011.10.032","article-title":"Adalimumab induces and maintains clinical remission in patients with moderate-to-severe ulcerative colitis","volume":"142","author":"Sandborn","year":"2012","journal-title":"Gastroenterology."},{"key":"2025063009413877400_CIT0004","doi-asserted-by":"crossref","first-page":"699","DOI":"10.1056\/NEJMoa1215734","article-title":"Vedolizumab as Induction and maintenance therapy for ulcerative colitis","volume":"369","author":"Feagan","year":"2013","journal-title":"N Engl J Med."},{"key":"2025063009413877400_CIT0005","doi-asserted-by":"crossref","first-page":"1280","DOI":"10.1056\/NEJMoa2033617","article-title":"Ozanimod as induction and maintenance therapy for ulcerative colitis","volume":"385","author":"Sandborn","year":"2021","journal-title":"N Engl J Med."},{"key":"2025063009413877400_CIT0006","doi-asserted-by":"crossref","first-page":"1723","DOI":"10.1056\/NEJMoa1606910","article-title":"Tofacitinib as induction and maintenance therapy for ulcerative colitis","volume":"376","author":"Sandborn","year":"2017","journal-title":"N Engl J Med."},{"key":"2025063009413877400_CIT0007","doi-asserted-by":"crossref","first-page":"790","DOI":"10.1093\/ecco-jcc\/jjad203","article-title":"Biologic therapy for inflammatory bowel disease: real-world comparative effectiveness and impact of drug sequencing in 13 222 patients within the UK IBD BioResource","volume":"18","author":"Kapizioni","year":"2024","journal-title":"J Crohns Colitis."},{"key":"2025063009413877400_CIT0008","doi-asserted-by":"crossref","first-page":"541","DOI":"10.1111\/apt.16723","article-title":"Trends in the use of biologicals and their treatment outcomes among patients with inflammatory bowel diseases\u2014a Danish nationwide cohort study","volume":"55","author":"Zhao","year":"2022","journal-title":"Aliment Pharmacol Ther."},{"key":"2025063009413877400_CIT0009","doi-asserted-by":"crossref","first-page":"712","DOI":"10.1093\/ecco-jcc\/jjac188","article-title":"Long-term colectomy rates of ulcerative colitis over 40 years of different therapeutic eras\u2013results from a western hungarian population-based inception cohort between 1977 and 2020","volume":"17","author":"Wetwittayakhlang","year":"2023","journal-title":"J Crohns Colitis."},{"key":"2025063009413877400_CIT0010","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1016\/j.cgh.2017.06.016","article-title":"Natural history of adult ulcerative colitis in population-based cohorts: a systematic review","volume":"16","author":"Fumery","year":"2018","journal-title":"Clin Gastroenterol Hepatol."},{"key":"2025063009413877400_CIT0011","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1093\/ecco-jcc\/jjy154","article-title":"Natural disease course of ulcerative colitis during the first five years of follow-up in a European population-based inception cohort-an Epi-IBD study","volume":"13","author":"Burisch","year":"2018","journal-title":"J Crohns Colitis."},{"key":"2025063009413877400_CIT0012","doi-asserted-by":"crossref","first-page":"588","DOI":"10.1136\/gutjnl-2013-304636","article-title":"East\u2013West gradient in the incidence of inflammatory bowel disease in Europe: the ECCO-EpiCom inception cohort","volume":"63","author":"Burisch","year":"2014","journal-title":"Gut."},{"key":"2025063009413877400_CIT0013","doi-asserted-by":"crossref","first-page":"1506","DOI":"10.1016\/j.crohns.2014.06.004","article-title":"Incidence and initial disease course of inflammatory bowel diseases in 2011 in Europe and Australia: results of the 2011 ECCO-EpiCom inception cohort","volume":"8","author":"Vegh","year":"2014","journal-title":"J Crohns Colitis."},{"key":"2025063009413877400_CIT0014","first-page":"287","article-title":"Crohn\u2019s disease\u2014occurrence, course and prognosis. An epidemiologic cohort-study","volume":"44","author":"Munkholm","year":"1997","journal-title":"Dan Med Bull."},{"key":"2025063009413877400_CIT0015","first-page":"400","article-title":"Ulcerative colitis: an epidemiological study based on a regional inception cohort, with special reference to disease course and prognosis","volume":"46","author":"Langholz","year":"1999","journal-title":"Dan Med Bull."},{"key":"2025063009413877400_CIT0016","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1080\/00365520802600961","article-title":"Clinical course during the first 10 years of ulcerative colitis: results from a population-based inception cohort (IBSEN Study)","volume":"44","author":"Solberg","year":"2009","journal-title":"Scand J Gastroenterol."},{"key":"2025063009413877400_CIT0017","doi-asserted-by":"crossref","first-page":"e351","DOI":"10.1016\/j.crohns.2013.02.006","article-title":"Incidence and natural history of ulcerative colitis in the Uppsala Region of Sweden 2005\u20132009\u2014results from the IBD Cohort of the Uppsala Region (ICURE)","volume":"7","author":"Sj\u00f6berg","year":"2013","journal-title":"J Crohns Colitis."},{"key":"2025063009413877400_CIT0018","doi-asserted-by":"crossref","first-page":"1030","DOI":"10.1016\/j.cgh.2024.08.006","article-title":"Thiopurines and the risk of cancer in patients with inflammatory bowel disease and reference individuals without inflammatory bowel disease\u2014a Danish Nationwide Cohort Study (1996-2018)","volume":"23","author":"Wewer","year":"2025","journal-title":"Clin Gastroenterol Hepatol."},{"key":"2025063009413877400_CIT0019","doi-asserted-by":"crossref","first-page":"2002","DOI":"10.1093\/ecco-jcc\/jjad106","article-title":"Lack of benefit for early escalation to advanced therapies in ulcerative colitis: critical appraisal of current evidence","volume":"17","author":"Burisch","year":"2023","journal-title":"J Crohns Colitis."},{"key":"2025063009413877400_CIT0020","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1093\/ecco-jcc\/jjv194","article-title":"Natural history of elderly-onset ulcerative colitis: results from a territory-wide inflammatory bowel disease registry","volume":"10","author":"Shi","year":"2016","journal-title":"J Crohns Colitis."},{"key":"2025063009413877400_CIT0021","doi-asserted-by":"crossref","first-page":"1200","DOI":"10.1093\/ecco-jcc\/jjx066","article-title":"Proximal disease extension in patients with limited ulcerative colitis: a danish population-based inception cohort","volume":"11","author":"Burisch","year":"2017","journal-title":"J Crohns Colitis."},{"key":"2025063009413877400_CIT0022","doi-asserted-by":"crossref","first-page":"458","DOI":"10.1016\/S2468-1253(23)00003-1","article-title":"The cost of inflammatory bowel disease in high-income settings: a Lancet Gastroenterology & Hepatology Commission","volume":"8","author":"Burisch","year":"2023","journal-title":"Lancet Gastroenterol Hepatol."}],"container-title":["Journal of Crohn's and Colitis"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ecco-jcc\/advance-article-pdf\/doi\/10.1093\/ecco-jcc\/jjaf089\/63421659\/jjaf089.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ecco-jcc\/article-pdf\/19\/6\/jjaf089\/63421659\/jjaf089.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ecco-jcc\/article-pdf\/19\/6\/jjaf089\/63421659\/jjaf089.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,30]],"date-time":"2025-06-30T13:41:45Z","timestamp":1751290905000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ecco-jcc\/article\/doi\/10.1093\/ecco-jcc\/jjaf089\/8155592"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6]]},"references-count":22,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2025,6,4]]}},"URL":"https:\/\/doi.org\/10.1093\/ecco-jcc\/jjaf089","relation":{},"ISSN":["1873-9946","1876-4479"],"issn-type":[{"value":"1873-9946","type":"print"},{"value":"1876-4479","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,6]]},"published":{"date-parts":[[2025,6]]},"article-number":"jjaf089"}}