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 ValenteAna 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

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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

Keywords

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

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    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