Document Detail


Crohn's disease in a southern European country: Montreal classification and clinical activity.
MedLine Citation:
PMID:  19235885     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Given the heterogeneous nature of Crohn's disease (CD), our aim was to apply the Montreal Classification to a large cohort of Portuguese patients with CD in order to identify potential predictive regarding the need for medical and/or surgical treatment. METHODS: A cross-sectional study was used based on data from an on-line registry of patients with CD. RESULTS: Of the 1692 patients with 5 or more years of disease, 747 (44%) were male and 945 (56%) female. On multivariate analysis the A2 group was an independent risk factor of the need for steroids (odds ratio [OR] 1.6, 95% confidence interval [CI] 1.1-2.3) and the A1 and A2 groups for immunosuppressants (OR 2.2; CI 1.2-3.8; OR 1.4; CI 1.0-2.0, respectively). An L3+L3(4) and L(4) location were risk factors for immunosuppression (OR 1.9; CI 1.5-2.4), whereas an L1 location was significantly associated with the need for abdominal surgery (P < 0.001). After 20 years of disease, less than 10% of patients persisted without steroids, immunosuppression, or surgery. The Montreal Classification allowed us to identify different groups of disease severity: A1 were more immunosuppressed without surgery, most of A2 patients were submitted to surgery, and 52% of L1+L1(4) patients were operated without immunosuppressants. CONCLUSIONS: Stratifying patients according to the Montreal Classification may prove useful in identifying different phenotypes with different therapies and severity. Most of our patients have severe disease.
Authors:
Fernando Magro; Francisco Portela; Paula Lago; João Ramos de Deus; Ana Vieira; Paula Peixe; Isabelle Cremers; José Cotter; Marília Cravo; Lourdes Tavares; Jorge Reis; Raquel Gonçalves; Horácio Lopes; Paulo Caldeira; Paula Ministro; Laura Carvalho; Luis Azevedo; Altamiro da Costa-Pereira;
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Inflammatory bowel diseases     Volume:  15     ISSN:  1536-4844     ISO Abbreviation:  Inflamm. Bowel Dis.     Publication Date:  2009 Sep 
Date Detail:
Created Date:  2009-08-26     Completed Date:  2009-11-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9508162     Medline TA:  Inflamm Bowel Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1343-50     Citation Subset:  IM    
Affiliation:
Portuguese Group of Studies of Inflammatory Bowel Diseases, Oporto University, Porto, Portugal. fm@med.up.pt
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Age of Onset
Cohort Studies
Crohn Disease / classification*,  drug therapy,  epidemiology*
Cross-Sectional Studies
Europe
Female
Humans
Immunosuppressive Agents / therapeutic use
Male
Middle Aged
Portugal / epidemiology
Registries
Risk Factors
Treatment Outcome
Young Adult
Chemical
Reg. No./Substance:
0/Immunosuppressive Agents
Investigator
Investigator/Affiliation:
Amadeu Corte Real Nunes / ; Ana Isabel Valente / ; Ana Isabel Vieira / ; Antónia Duarte / ; António Marques / ; Antonio Queiroz / ; Bernardino Ribeiro / ; Carolina Duesca / ; Celeste Fátima Viveiros / ; Cidalina Caetano / ; Claudia Sequeira / ; David Horta / ; Edgar Gencsi / ; Estela Monteiro / ; Fernando Magro / ; Filipe Gomes Silva / ; Francisco Portela / ; Glória Marinho / ; Helder Cardoso / ; Helena Vasconcelos / ; Helena Sousa / ; Henrique Morna / ; Horácio Lopes / ; Isabel Bastos / ; Isabel Medeiros / ; Isabel Seves / ; Isadora Rosa / ; João Baranda / ; João Ramos de Deus / ; Jorge Amil Dias / ; J Godinho Lopes / ; João Freitas / ; J Pinto de Matos / ; Jorge Reis / ; Jorge Vieira / ; Jose Cotter / ; José Estevens / ; J M Ribeiro / ; Laura Carvalho / ; Leopoldo Matos / ; Luís Correia / ; Luís Jasmins / ; Luis Lebre / ; Luísa Barros / ; Luísa Gloria / ; Lurdes Tavares / ; Marília Cravo / ; Margarida Marques / ; Marie Isabelle Cremers / ; Maria do Rosário Maldonado / ; Manuel Correia / ; Maria de Lurdes Gonçalves / ; Mário César / ; Miguel Areia / ; Manuela Ferreira / ; Mário Júlio Campos / ; Marta Salgado / ; Nuno Almeida / ; Paulo Andrade / ; Paula Lago / ; Paula Ministro / ; Paula Moura Santos / ; Paula Peixe / ; Paulo Caldeira / ; Paulo Freire / ; Pedro Martins / ; Raquel Gonçalves / ; Ricardo Ferreira / ; Ricardo Freire / ; Rui Loureiro / ; Rui Sousa / ; Rute Cerqueira / ; Salazar Sousa / ; Salomé Costa Lima / ; Sara Folgado Alberto / ; Silvia Leite / ; Sofia Mendes / ; Sónia Barroso / ; Sandra Lopes / ; Sónia Nobre / ; Tiago Bana e Costa / ; Vítor Fernandes /

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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