Course of Disease in Patients with Microscopic Colitis: A European Prospective Incident Cohort Study

Bas P.M. Verhaegh, Andreas Münch, Danila Guagnozzi, Signe Wildt, Wojciech Cebula, Andreea R. Diac, Fernando Fernández-Bañares, Magid A.R. Al-Khalaf, Natalia Pedersen, Juozas Kupcinskas, Johan Bohr, Gilles Macaigne, Alfredo J. Lucendo, Ivan Lyutakov, Gian Eugenio Tontini, Flavia Pigò, Evangelos Russo, Henrik Hjortswang, Stephan Miehlke, Lars K. Munck

Research output: Contribution to journalArticlepeer-review


BACKGROUND AND AIMS: 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 healthcare professionals on the expected course of the disease and real-life response to therapy are warranted. METHODS: A prospective, pan-European, multi-centre, 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. RESULTS: 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. CONCLUSIONS: A minority of MC patients follow a quiescent disease course with spontaneous clinical improvement, whereas the majority suffer a chronic active or relapsing disease course during the first year after diagnosis, with persisting symptoms accompanied by a significantly impaired quality of life.

Original languageEnglish
Pages (from-to)1174-1183
Number of pages10
JournalJournal of Crohn's & colitis
Issue number7
Publication statusPublished - Jul 5 2021


  • disease activity
  • disease course
  • Microscopic colitis
  • prognosis
  • prospective cohort study
  • treatment

ASJC Scopus subject areas

  • Gastroenterology


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