Crohn's disease in a Southern European country

Montreal classification and clinical activity

Fernando Magro, Francisco Portela, Paula Lago, João Ramos De Deus, Ana Vieira, Paula Peixe, Marie 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, Amadeu Corte Real Nunes, Ana Isabel Valente & 67 others 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, Filipe Gomes Silva, Glória Marinho, Helder Cardoso, Helena Vasconcelos, Helena Sousa, Henrique Morna, Isabel Bastos, Isabel Medeiros, Isabel Seves, Isadora Rosa, João Baranda, Jorge Amil Dias, J. Godinho Lopes, João Freitas, J. De Pinto Matos, Jorge Vieira, José Estevens, J. M. Ribeiro, Leopoldo Matos, Luís Correia, Luís Jasmins, Luis Lebre, Luísa Barros, Luísa Gloria, Lurdes Tavares, 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 Moura Santos, Paulo Freire, Pedro Martins, 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 Costa, Vítor Fernandes

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

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+L34 and L4 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+L14 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.

Original languageEnglish
Pages (from-to)1343-1350
Number of pages8
JournalInflammatory Bowel Diseases
Volume15
Issue number9
DOIs
Publication statusPublished - 26 Nov 2009

Fingerprint

Crohn Disease
Odds Ratio
varespladib methyl
Confidence Intervals
Immunosuppressive Agents
Immunosuppression
Steroids
Galectin 3
Registries
Multivariate Analysis
Cross-Sectional Studies
Phenotype
Therapeutics

Keywords

  • Clinical activity
  • Crohn's disease
  • Montreal classification
  • Portugal
  • Predictive factors
  • Southern Europe

Cite this

Magro, F., Portela, F., Lago, P., De Deus, J. R., Vieira, A., Peixe, P., ... Fernandes, V. (2009). Crohn's disease in a Southern European country: Montreal classification and clinical activity. Inflammatory Bowel Diseases, 15(9), 1343-1350. https://doi.org/10.1002/ibd.20901
Magro, Fernando ; Portela, Francisco ; Lago, Paula ; De Deus, João Ramos ; Vieira, Ana ; Peixe, Paula ; Cremers, Marie Isabelle ; Cotter, José ; Cravo, Marília ; Tavares, Lourdes ; Reis, Jorge ; Gonçalves, Raquel ; Lopes, Horácio ; Caldeira, Paulo ; Ministro, Paula ; Carvalho, Laura ; Azevedo, Luis ; Da Costa-Pereira, Altamiro ; Nunes, Amadeu Corte Real ; Valente, Ana Isabel ; Vieira, Ana Isabel ; Duarte, Antónia ; Marques, António ; Queiroz, Antonio ; Ribeiro, Bernardino ; Duesca, Carolina ; Viveiros, Celeste Fátima ; Caetano, Cidalina ; Sequeira, Claudia ; Horta, David ; Gencsi, Edgar ; Monteiro, Estela ; Silva, Filipe Gomes ; Marinho, Glória ; Cardoso, Helder ; Vasconcelos, Helena ; Sousa, Helena ; Morna, Henrique ; Bastos, Isabel ; Medeiros, Isabel ; Seves, Isabel ; Rosa, Isadora ; Baranda, João ; Dias, Jorge Amil ; Lopes, J. Godinho ; Freitas, João ; Matos, J. De Pinto ; Vieira, Jorge ; Estevens, José ; Ribeiro, J. M. ; Matos, Leopoldo ; Correia, Luís ; Jasmins, Luís ; Lebre, Luis ; Barros, Luísa ; Gloria, Luísa ; Tavares, Lurdes ; Marques, Margarida ; Cremers, Marie Isabelle ; Maldonado, Maria Do Rosário ; Correia, Manuel ; Gonçalves, Maria De Lurdes ; César, Mário ; Areia, Miguel ; Ferreira, Manuela ; Campos, Mário Júlio ; Salgado, Marta ; Almeida, Nuno ; Andrade, Paulo ; Santos, Paula Moura ; Freire, Paulo ; Martins, Pedro ; Ferreira, Ricardo ; Freire, Ricardo ; Loureiro, Rui ; Sousa, Rui ; Cerqueira, Rute ; Sousa, Salazar ; Lima, Salomé Costa ; Alberto, Sara Folgado ; Leite, Silvia ; Mendes, Sofia ; Barroso, Sónia ; Lopes, Sandra ; Nobre, Sónia ; Costa, Tiago Bana ; Fernandes, Vítor. / Crohn's disease in a Southern European country : Montreal classification and clinical activity. In: Inflammatory Bowel Diseases. 2009 ; Vol. 15, No. 9. pp. 1343-1350.
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title = "Crohn's disease in a Southern European country: Montreal classification and clinical activity",
abstract = "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+L34 and L4 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+L14 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.",
keywords = "Clinical activity, Crohn's disease, Montreal classification, Portugal, Predictive factors, Southern Europe",
author = "Fernando Magro and Francisco Portela and Paula Lago and {De Deus}, {Jo{\~a}o Ramos} and Ana Vieira and Paula Peixe and Cremers, {Marie Isabelle} and Jos{\'e} Cotter and Mar{\'i}lia Cravo and Lourdes Tavares and Jorge Reis and Raquel Gon{\cc}alves and Hor{\'a}cio Lopes and Paulo Caldeira and Paula Ministro and Laura Carvalho and Luis Azevedo and {Da Costa-Pereira}, Altamiro and Nunes, {Amadeu Corte Real} and Valente, {Ana Isabel} and Vieira, {Ana Isabel} and Ant{\'o}nia Duarte and Ant{\'o}nio Marques and Antonio Queiroz and Bernardino Ribeiro and Carolina Duesca and Viveiros, {Celeste F{\'a}tima} and Cidalina Caetano and Claudia Sequeira and David Horta and Edgar Gencsi and Estela Monteiro and Silva, {Filipe Gomes} and Gl{\'o}ria Marinho and Helder Cardoso and Helena Vasconcelos and Helena Sousa and Henrique Morna and Isabel Bastos and Isabel Medeiros and Isabel Seves and Isadora Rosa and Jo{\~a}o Baranda and Dias, {Jorge Amil} and Lopes, {J. Godinho} and Jo{\~a}o Freitas and Matos, {J. De Pinto} and Jorge Vieira and Jos{\'e} Estevens and Ribeiro, {J. M.} and Leopoldo Matos and Lu{\'i}s Correia and Lu{\'i}s Jasmins and Luis Lebre and Lu{\'i}sa Barros and Lu{\'i}sa Gloria and Lurdes Tavares and Margarida Marques and Cremers, {Marie Isabelle} and Maldonado, {Maria Do Ros{\'a}rio} and Manuel Correia and Gon{\cc}alves, {Maria De Lurdes} and M{\'a}rio C{\'e}sar and Miguel Areia and Manuela Ferreira and Campos, {M{\'a}rio J{\'u}lio} and Marta Salgado and Nuno Almeida and Paulo Andrade and Santos, {Paula Moura} and Paulo Freire and Pedro Martins and Ricardo Ferreira and Ricardo Freire and Rui Loureiro and Rui Sousa and Rute Cerqueira and Salazar Sousa and Lima, {Salom{\'e} Costa} and Alberto, {Sara Folgado} and Silvia Leite and Sofia Mendes and S{\'o}nia Barroso and Sandra Lopes and S{\'o}nia Nobre and Costa, {Tiago Bana} and V{\'i}tor Fernandes",
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Magro, F, Portela, F, Lago, P, De Deus, JR, Vieira, A, Peixe, P, Cremers, MI, Cotter, J, Cravo, M, Tavares, L, Reis, J, Gonçalves, R, Lopes, H, Caldeira, P, Ministro, P, Carvalho, L, Azevedo, L, Da Costa-Pereira, A, Nunes, ACR, Valente, AI, Vieira, AI, Duarte, A, Marques, A, Queiroz, A, Ribeiro, B, Duesca, C, Viveiros, CF, Caetano, C, Sequeira, C, Horta, D, Gencsi, E, Monteiro, E, Silva, FG, Marinho, G, Cardoso, H, Vasconcelos, H, Sousa, H, Morna, H, Bastos, I, Medeiros, I, Seves, I, Rosa, I, Baranda, J, Dias, JA, Lopes, JG, Freitas, J, Matos, JDP, Vieira, J, Estevens, J, Ribeiro, JM, Matos, L, Correia, L, Jasmins, L, Lebre, L, Barros, L, Gloria, L, Tavares, L, Marques, M, Cremers, MI, Maldonado, MDR, Correia, M, Gonçalves, MDL, César, M, Areia, M, Ferreira, M, Campos, MJ, Salgado, M, Almeida, N, Andrade, P, Santos, PM, Freire, P, Martins, P, Ferreira, R, Freire, R, Loureiro, R, Sousa, R, Cerqueira, R, Sousa, S, Lima, SC, Alberto, SF, Leite, S, Mendes, S, Barroso, S, Lopes, S, Nobre, S, Costa, TB & Fernandes, V 2009, 'Crohn's disease in a Southern European country: Montreal classification and clinical activity', Inflammatory Bowel Diseases, vol. 15, no. 9, pp. 1343-1350. https://doi.org/10.1002/ibd.20901

Crohn's disease in a Southern European country : Montreal classification and clinical activity. / Magro, Fernando; Portela, Francisco; Lago, Paula; De Deus, João Ramos; Vieira, Ana; Peixe, Paula; Cremers, Marie Isabelle; Cotter, José; Cravo, Marília; Tavares, Lourdes; Reis, Jorge; Gonçalves, Raquel; Lopes, Horácio; Caldeira, Paulo; Ministro, Paula; Carvalho, Laura; Azevedo, Luis; Da Costa-Pereira, Altamiro; Nunes, Amadeu Corte Real; Valente, Ana Isabel; Vieira, Ana Isabel; Duarte, Antónia; Marques, António; Queiroz, Antonio; Ribeiro, Bernardino; Duesca, Carolina; Viveiros, Celeste Fátima; Caetano, Cidalina; Sequeira, Claudia; Horta, David; Gencsi, Edgar; Monteiro, Estela; Silva, Filipe Gomes; Marinho, Glória; Cardoso, Helder; Vasconcelos, Helena; Sousa, Helena; Morna, Henrique; Bastos, Isabel; Medeiros, Isabel; Seves, Isabel; Rosa, Isadora; Baranda, João; Dias, Jorge Amil; Lopes, J. Godinho; Freitas, João; Matos, J. De Pinto; Vieira, Jorge; Estevens, José; Ribeiro, J. M.; Matos, Leopoldo; Correia, Luís; Jasmins, Luís; Lebre, Luis; Barros, Luísa; Gloria, Luísa; Tavares, Lurdes; Marques, Margarida; Cremers, Marie Isabelle; Maldonado, Maria Do Rosário; Correia, Manuel; Gonçalves, Maria De Lurdes; César, Mário; Areia, Miguel; Ferreira, Manuela; Campos, Mário Júlio; Salgado, Marta; Almeida, Nuno; Andrade, Paulo; Santos, Paula Moura; Freire, Paulo; Martins, Pedro; Ferreira, Ricardo; Freire, Ricardo; Loureiro, Rui; Sousa, Rui; Cerqueira, Rute; Sousa, Salazar; Lima, Salomé Costa; Alberto, Sara Folgado; Leite, Silvia; Mendes, Sofia; Barroso, Sónia; Lopes, Sandra; Nobre, Sónia; Costa, Tiago Bana; Fernandes, Vítor.

In: Inflammatory Bowel Diseases, Vol. 15, No. 9, 26.11.2009, p. 1343-1350.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Crohn's disease in a Southern European country

T2 - Montreal classification and clinical activity

AU - Magro, Fernando

AU - Portela, Francisco

AU - Lago, Paula

AU - De Deus, João Ramos

AU - Vieira, Ana

AU - Peixe, Paula

AU - Cremers, Marie Isabelle

AU - Cotter, José

AU - Cravo, Marília

AU - Tavares, Lourdes

AU - Reis, Jorge

AU - Gonçalves, Raquel

AU - Lopes, Horácio

AU - Caldeira, Paulo

AU - Ministro, Paula

AU - Carvalho, Laura

AU - Azevedo, Luis

AU - Da Costa-Pereira, Altamiro

AU - Nunes, Amadeu Corte Real

AU - Valente, Ana Isabel

AU - Vieira, Ana Isabel

AU - Duarte, Antónia

AU - Marques, António

AU - Queiroz, Antonio

AU - Ribeiro, Bernardino

AU - Duesca, Carolina

AU - Viveiros, Celeste Fátima

AU - Caetano, Cidalina

AU - Sequeira, Claudia

AU - Horta, David

AU - Gencsi, Edgar

AU - Monteiro, Estela

AU - Silva, Filipe Gomes

AU - Marinho, Glória

AU - Cardoso, Helder

AU - Vasconcelos, Helena

AU - Sousa, Helena

AU - Morna, Henrique

AU - Bastos, Isabel

AU - Medeiros, Isabel

AU - Seves, Isabel

AU - Rosa, Isadora

AU - Baranda, João

AU - Dias, Jorge Amil

AU - Lopes, J. Godinho

AU - Freitas, João

AU - Matos, J. De Pinto

AU - Vieira, Jorge

AU - Estevens, José

AU - Ribeiro, J. M.

AU - Matos, Leopoldo

AU - Correia, Luís

AU - Jasmins, Luís

AU - Lebre, Luis

AU - Barros, Luísa

AU - Gloria, Luísa

AU - Tavares, Lurdes

AU - Marques, Margarida

AU - Cremers, Marie Isabelle

AU - Maldonado, Maria Do Rosário

AU - Correia, Manuel

AU - Gonçalves, Maria De Lurdes

AU - César, Mário

AU - Areia, Miguel

AU - Ferreira, Manuela

AU - Campos, Mário Júlio

AU - Salgado, Marta

AU - Almeida, Nuno

AU - Andrade, Paulo

AU - Santos, Paula Moura

AU - Freire, Paulo

AU - Martins, Pedro

AU - Ferreira, Ricardo

AU - Freire, Ricardo

AU - Loureiro, Rui

AU - Sousa, Rui

AU - Cerqueira, Rute

AU - Sousa, Salazar

AU - Lima, Salomé Costa

AU - Alberto, Sara Folgado

AU - Leite, Silvia

AU - Mendes, Sofia

AU - Barroso, Sónia

AU - Lopes, Sandra

AU - Nobre, Sónia

AU - Costa, Tiago Bana

AU - Fernandes, Vítor

PY - 2009/11/26

Y1 - 2009/11/26

N2 - 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+L34 and L4 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+L14 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.

AB - 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+L34 and L4 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+L14 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.

KW - Clinical activity

KW - Crohn's disease

KW - Montreal classification

KW - Portugal

KW - Predictive factors

KW - Southern Europe

UR - http://www.scopus.com/inward/record.url?scp=70449698214&partnerID=8YFLogxK

U2 - 10.1002/ibd.20901

DO - 10.1002/ibd.20901

M3 - Article

VL - 15

SP - 1343

EP - 1350

JO - Inflammatory Bowel Diseases

JF - Inflammatory Bowel Diseases

SN - 1078-0998

IS - 9

ER -