P694 Disease course during the first five years following diagnosis in a prospective European population-based inception cohort – the ECCO-EpiCom cohort

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Background: The EpiCom-cohort is a European prospective population-based cohort of unselected, uniformly diagnosed patients with inflammatory bowel disease (IBD) diagnosed in 2010 in centres from Western and Eastern European countries. The cohort aims at describing differences in occurrence, treatment strategies, disease course and prognosis within Europe. Methods: Patients were followed each 3rd month for the first year after diagnosis and then according to the treating physician for the 2–5th year of follow-up. Clinical data on surgery, hospitalizations and medical treatment incl. biological therapy were captured prospectively throughout the follow-up period and entered in a validated web-based database. The aim of the study was to investigate differences in disease outcome and the use of biologicals between Eastern and Western Europe during the first 5 years of follow-up. Associations between outcomes and covariates were analysed by Cox regression analyses. Results: A total of 1,148 patients aged 15 years or older from 26 centres in 13 Western and 7 Eastern European countries were followed prospectively of whom 623 (54%) had ulcerative colitis (UC), 425 (37%) had Crohn's disease (CD), and 100 (9%) had IBD unclassified (IBDU). At 5-years follow up a total of 123 (11%) patients had undergone 1st surgery (resections or colectomy), 190 (17%) had received biological therapy and 289 (25%) were hospitalized. Crude annual rates for CD and UC patients regarding surgery, biological treatment and hospitalization are shown in Table 1. Significantly more patients in Western Europe received biological therapy (p<0.05), while surgery and hospitalization rates did not differ between the regions at 1, 3 and 5-year follow-up (p>0.05). Cox regression analysis showed that in CD only stricturing or penetrating disease carried the highest risk for surgery and hospitalization while younger age was associated with the risk for receiving biological therapy. In UC only females and patients with extensive disease carried the highest risk for hospitalization while younger age was associated with the risk for receiving biological therapy. Table 1. Crude rates for surgery, biological therapy and hospitalization after 1 and 3 years follow-up in the EpiCom-cohort Conclusions: In an era of early and aggressive immunological therapy, surgery and hospitalization rates for CD and UC patients were similar in Eastern and Western Europe and comparable to population-based cohorts from the past decade and pre-biological era. This similar disease course was in spite of more early and aggressive treatment with biologicals, with significantly more CD and UC patients in Western Europe receiving biologicals.

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