title: Clinical course of Crohn's disease during the first 5 years. Results from a population-based cohort in Sweden (ICURE) diagnosed 2005-2009.
abstract: OBJECTIVE
  The aim of the study was to describe the medical treatment, change in phenotype, need for surgery and IBD-associated mortality during the first 5 years after diagnosis.
  
  
  METHODS
  Patients diagnosed with Crohn's disease including all age groups in the Uppsala healthcare region in the middle of Sweden 2005-2009 were included in the study. Medical notes were scrutinised and patients contacted. Out of 269 patients, 260 (96.3%) could be followed for 5 full years or until death.
  
  
  RESULTS
  The following drugs were used: 5-ASA 66.7%, systemic steroids 76.4%, antimetabolites 56.7% and anti-TNF 20.3%. Described with the Montreal classification, the proportion with inflammatory behaviour decreased from 78.1% to 74.0% from diagnosis to end of the observation, patients with stricturing behaviour increased from 13.0% to 15.4% and patients with penetrating behaviour increased from 8.9% to 10.6%. After the first year, 12.4% had been treated with intestinal resection or colectomy, a figure that increased to 14.8 after 5 years. Two patients suffered an IBD-related death.
  
  
  CONCLUSIONS
  Compared to similar patient cohorts, the present study demonstrates that although the course of Crohn's disease seems difficult to change during the first year after diagnosis, the following years up to 5 years shows a more benign course than has usually been described earlier.
authors.affiliation: a Department of Medical Sciences , Uppsala University , Uppsala , Sweden.
authors.forename: Anders
authors.initials: A
authors.lastname: Rönnblom
authors.affiliation: b Department of Internal Medicine , Mariehamn , Åland , Finland.
authors.forename: Tommy
authors.initials: T
authors.lastname: Holmström
authors.affiliation: c Department of Surgery , Uppsala University , Uppsala , Sweden.
authors.forename: Urban
authors.initials: U
authors.lastname: Karlbom
authors.affiliation: d Department of Internal Medicine , Mälar Hospital , Eskilstuna , Sweden.
authors.forename: Hans
authors.initials: H
authors.lastname: Tanghöj
authors.affiliation: a Department of Medical Sciences , Uppsala University , Uppsala , Sweden.
authors.forename: Mari
authors.initials: M
authors.lastname: Thörn
authors.affiliation: e Department of Internal Medicine , Falu Hospital , Falun , Sweden.
authors.forename: Daniel
authors.initials: D
authors.lastname: Sjöberg
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000963:Antimetabolites / Q000627:therapeutic use; D002648:Child; D003113:Colonoscopy; D003424:Crohn Disease / Q000401:mortality* / Q000628:therapy*; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D019804:Mesalamine / Q000627:therapeutic use; D008875:Middle Aged; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D013256:Steroids / Q000627:therapeutic use; D013548:Sweden / Q000453:epidemiology; D013997:Time Factors; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D000963:Antimetabolites; D013256:Steroids; D014409:Tumor Necrosis Factor-alpha; D019804:Mesalamine
keywords: Clinical course; Crohn’s disease; epidemiology