Prevalence and Natural History of Microscopic Colitis: A Population-Based Study With Long-term Clinical Follow-up in Terrassa, Spain

Background and aims: Few studies have assessed the prevalence of microscopic colitis (MC) and the natural history of this disease is not well known. The aim of this study was to evaluate the prevalence rate of MC, the burden of disease in terms of loss of health and the long-term natural history of...

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Bibliographic Details
Published in:Journal of Crohn's and colitis 2016-07, Vol.10 (7), p.805-811
Main Authors: Fernández-Bañares, Fernando, Zabana, Yamile, Aceituno, Montserrat, Ruiz, Laura, Salas, Antonio, Esteve, Maria
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Colitis, Microscopic - diagnosis
Colitis, Microscopic - epidemiology
Colitis, Microscopic - therapy
Cost of Illness
Disease Progression
Female
Follow-Up Studies
Humans
Male
Middle Aged
Prevalence
Prognosis
Retrospective Studies
Spain - epidemiology
Young Adult
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Summary:Background and aims: Few studies have assessed the prevalence of microscopic colitis (MC) and the natural history of this disease is not well known. The aim of this study was to evaluate the prevalence rate of MC, the burden of disease in terms of loss of health and the long-term natural history of MC in a population-based cohort study. Methods: Cases were obtained from the pathology department registry Hospital Universitari Mutua Terrassa. Belonging to the catchment area, maintaining residence in that area, and being alive on August 31, 2014 were confirmed for each case. Adjusted prevalence rates were calculated. Current active drugs for MC and diarrhoea persistence in every patient were recorded. Results: The prevalence rate of MC was 107 per 105 inhabitants. The rate of patients with active disease, i.e. those representing the true burden of the disease in terms of loss of health, was 31 per 105 inhabitants. After a follow-up of 7.8±0.38 years from diagnosis, 75% of the patients experienced prolonged disease remission, defined as clinical remission without requiring drugs for 1 year or more. The only variable associated with prolonged MC remission was how clinical remission was achieved (spontaneous 93.3%, drug-induced, 60.5%; odds ratio 8.4, 95% confidence interval 2.7–26). Conclusions: The rate of patients with MC and active disease, which represents the true disease burden in terms of loss of health, is low. Most patients with MC experience prolonged disease remission, with key differences between spontaneous and drug-induced clinical remission.
ISSN:1873-9946
1876-4479
DOI:10.1093/ecco-jcc/jjw037