Course of disease in patients with microscopic colitis - a European prospective incident cohort study

• Published in: Journal of Crohn's and colitis Vol. 15; no. 7; pp. 1174 - 1183
• Main Authors: Verhaegh, Bas P M, Münch, Andreas, Guagnozzi, Danila, Wildt, Signe, Cebula, W, Diac, A R, Fernández-Bañares, Fernando, Al-Khalaf, M A R, Pedersen, N, Kupcinskas, Juozas, Bohr, Johan, Macaigne, Gilles, Lucendo, Alfredo J, Lyutakov, Ivan, Tontini, Gian-Eugenio, Pigò, Flavia, Russo, E, Hjortswang, Henrik, Miehlke, Stephan, Munck, Lars K
• Format: Journal Article
• Language: English
• Published: England 05.07.2021
• Subjects: disease activity; disease course; Microscopic colitis; prognosis; prospective cohort study; treatment; disease activity; treatment; prospective cohort study; disease course; prognosis; Microscopic colitis
• ISSN: 1873-9946; 1876-4479; 1876-4479
• DOI: 10.1093/ecco-jcc/jjab007

The disease course of microscopic colitis (MC) is considered chronic but benign. However, this assumption is based on mainly retrospective studies, reporting on incomplete follow-up of selective cohorts. Systematic, prospective and unbiased data to inform patients and health care professionals on the expected course of the disease and real-life response to therapy are warranted. A prospective, pan-European, multi-center, web-based registry was established. Incident cases of MC were included. Data on patient characteristics, symptoms, treatment and quality of life were systematically registered at baseline and during real-time follow-up. Four disease course phenotypes were discriminated and described. Among 381 cases with complete 1-year follow-up, 49% had a chronic active or relapsing disease course, 40% achieved sustained remission after treatment and 11% had a quiescent course. In general, symptoms and quality of life improved after 3 months of follow-up. A relapsing or chronic active disease course was associated with significantly more symptoms and impaired quality of life after 1 year. A minority of MC patients follow a quiescent disease course with spontaneous clinical improvement, whereas the majority suffers a chronic active or relapsing disease course during the first year after diagnosis, with persisting symptoms accompanied by a significantly impaired quality of life.