DISEASE-ACTIVITY COURSES IN A REGIONAL COHORT OF CROHNS-DISEASE PATIENTS

Background: The study was a follow-up of an inception cohort of 373 pa tients with Crohn's disease. Methods: Annual assessments, life table a nalyses, and Markov chain analyses, estimating the probability for rem ission and relapse with time, and working capacity were carried out. R esults: The clinical course of Crohn's disease differs markedly over t ime, from ever-relapsing cases to a quiescent course with remission fo r several years, interrupted by years with relapse. No predictive fact ors have been found for the subsequent course with regard to age, sex, extent of disease at diagnosis, and treatment in the year of diagnosi s. The relapse rate within the year of diagnosis and the following 2 y ears, however, does correlate positively (p = 0.00001) with the relaps e rate in the following 5 years. Furthermore, the relapse rate for 1 y ear during the disease course influences the relapse rate the followin g year, indicating a disease pattern over time with waves of at least 2 years' duration. A slight tendency towards burning out was found. Th e disease course reflected in working capacity for the patients showed that a minor part-up to 15% after 15 years-will become incapable and obtain disablement pension, while 75% of the patients each year are fu lly capable of work. Within 10 years 50% of the patients will not have experienced any year with impaired capacity for work.