Outcomes and Reclassification Patterns in Inflammatory Bowel Disease Unclassified: A Multicenter Study Matched With Ulcerative Colitis From Spanish ENEIDA Registry
21 affiliations
- 1Hospital de Viladecans Viladecans Spain
- 2Hospital del Mar Medical Research Institute (IMIM) Hospital del Mar Barcelona Spain
- 3Instituto de Investigación IDIVAL Hospital Universitario Marqués de Valdecilla Santander Spain
- 4Instituto de Investigación Biosanitaria del Principado de Asturias (ISPA) Hospital Universitario Central de Asturias Oviedo Spain
- 5Gerencia Regional de Salud de Castilla y León (SACYL) Hospital Universitario Río Hortega Valladolid Spain
- 6Complexo Hospitalario Universitario de Ourense Ourense Spain
- 7Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) Hospital Clínic de Barcelona, Centro de Investigación Biomédica en Red Enfermedades Hepáticas y Digestivas (CIBERehd) Barcelona Spain
- 8Hospital Universitario San Jorge Huesca Spain
- 9Consorci Sanitari de Terrassa Terrassa Spain
- 10Hospital Universitari de Bellvitge Hospitalet de Llobregat L'Hospitalet de Llobregat Spain
- 11Inflammatory Bowel Disease Research Group, Health Research Institute La Fe (IIS La Fe). IBD Unit, Gastroenterology Department La Fe University and Polytechnic Hospital Valencia Spain
- 12Instituto de Investigación Sanitaria Princesa (IIS‐Princesa) Hospital Universitario de La Princesa, Universidad Autónoma de Madrid (UAM), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD) Madrid Spain
- 13Hospital Universitario Nuestra Señora de Candelaria Santa Cruz de Tenerife Spain
- 14Hospital Universitario de Canarias Santa Cruz de Tenerife Spain
- 15Hospital General Universitario de Ciudad Real Ciudad Real Spain
- 16Fundación Galega de Investigación Sanitaria (IDIS) Hospital Clínico Universitario de Santiago Santiago de Compostela Spain
- 17ISABIAL Hospital General Universitario Dr Balmis de Alicante Alicante Spain
- 18Instituto Biodonostia Universidad del País Vasco (UPV/EHU), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd) San Sebastián Spain
- 19Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd) Hospital Universitari Mutua Terrassa Terrassa Spain
- 20Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd) Hospital Universitari Germans Trias i Pujol Badalona Spain
- 21Universitat Autònoma de Barcelona Barcelona Spain
Abstract
Background and Aim: Around 10% of patients with inflammatory bowel disease do not fulfill the diagnostic criteria for Crohn's disease (CD) or ulcerative colitis (UC). These cases are labelled as inflammatory bowel disease unclassified (IBDU). The aim of the study was to compare therapeutic requirements in patients with IBDU and UC and to identify predictive factors of reclassification.
Methods: This was a multicenter retrospective cohort study based on the ENEIDA registry. Patients diagnosed with IBDU or indeterminate colitis between January 2010 and December 2016 were included. All cases were matched by sex, age at diagnosis, and disease extent with at least two UC patients from the same hospital. The Kaplan–Meier method was performed to assess diagnostic changes during follow‐up. Fine–Gray competing‐risks regression analysis identified predictive factors of reclassification.
Results: Two hundred and nine IBDU patients and 465 UC patients were included. After a median follow‐up of 90 months, no significant differences were observed in the use of immunomodulator (37.3% vs. 37%, p = 0.934) and advanced therapies (29.2% vs. 23.9%, p = 0.143) between IBDU and UC. No statistical differences were found in the surgical rates (5.7% vs. 4.7%, p = 0.579). Overall, 59 IBDU patients (28.2%) were reclassified (30 UC and 29 CD). Baseline extensive colitis was associated with a lower probability of subsequent reclassification to UC (SHR: 0.33; 95% CI: 0.12–0.91). No independent predictive factors for reclassification to CD were identified.
Conclusions: Therapeutic management of IBDU and UC patients tended to be similar. Two‐thirds of patients remained classified as IBDU.
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BibTeX
@article{gonzalezvivo2026outcomes,
title = {{Outcomes and Reclassification Patterns in Inflammatory Bowel Disease Unclassified: A Multicenter Study Matched With Ulcerative Colitis From Spanish ENEIDA Registry}},
author = {M. González‐Vivó and B. Castro Senosiain and I. Pérez‐Martínez and J. Barrio and P. Vega Villaamil and B. Caballol Oliva and V. Pedrera Roman and M. Piqueras Cano and F. Rodríguez Moranta and M. Iborra and M. J. Casanova and J. P. Gisbert and C. Tardillo Marin and L. Ramos and M. Urpi‐Ferreruela and R. H. Lorente Poyatos and M. Barreiro‐de Acosta and O. Belen Galipienso and L. Bujanda and Y. Zabana and F. Murciano and E. Domènech and L. Márquez‐Mosquera and ENEIDA registry of GETECCU},
journal = {Journal of Gastroenterology and Hepatology},
year = {2026},
month = sep,
doi = {10.1111/jgh.70745},
url = {https://doi.org/10.1111/jgh.70745},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Outcomes and Reclassification Patterns in Inflammatory Bowel Disease Unclassified: A Multicenter Study Matched With Ulcerative Colitis From Spanish ENEIDA Registry
AU - M. González‐Vivó
AU - B. Castro Senosiain
AU - I. Pérez‐Martínez
AU - J. Barrio
AU - P. Vega Villaamil
AU - B. Caballol Oliva
AU - V. Pedrera Roman
AU - M. Piqueras Cano
AU - F. Rodríguez Moranta
AU - M. Iborra
AU - M. J. Casanova
AU - J. P. Gisbert
AU - C. Tardillo Marin
AU - L. Ramos
AU - M. Urpi‐Ferreruela
AU - R. H. Lorente Poyatos
AU - M. Barreiro‐de Acosta
AU - O. Belen Galipienso
AU - L. Bujanda
AU - Y. Zabana
AU - F. Murciano
AU - E. Domènech
AU - L. Márquez‐Mosquera
AU - ENEIDA registry of GETECCU
PY - 2026
DA - 2026/09/21
JO - Journal of Gastroenterology and Hepatology
DO - 10.1111/jgh.70745
UR - https://doi.org/10.1111/jgh.70745
AB - Background and Aim: Around 10% of patients with inflammatory bowel disease do not fulfill the diagnostic criteria for Crohn's disease (CD) or ulcerative colitis (UC). These cases are labelled as inflammatory bowel disease unclassified (IBDU). The aim of the study was to compare therapeutic requirements in patients with IBDU and UC and to identify predictive factors of reclassification. Methods: This was a multicenter retrospective cohort study based on the ENEIDA registry. Patients diagnosed with IBDU or indeterminate colitis between January 2010 and December 2016 were included. All cases were matched by sex, age at diagnosis, and disease extent with at least two UC patients from the same hospital. The Kaplan–Meier method was performed to assess diagnostic changes during follow‐up. Fine–Gray competing‐risks regression analysis identified predictive factors of reclassification. Results: Two hundred and nine IBDU patients and 465 UC patients were included. After a median follow‐up of 90 months, no significant differences were observed in the use of immunomodulator (37.3% vs. 37%, p = 0.934) and advanced therapies (29.2% vs. 23.9%, p = 0.143) between IBDU and UC. No statistical differences were found in the surgical rates (5.7% vs. 4.7%, p = 0.579). Overall, 59 IBDU patients (28.2%) were reclassified (30 UC and 29 CD). Baseline extensive colitis was associated with a lower probability of subsequent reclassification to UC (SHR: 0.33; 95% CI: 0.12–0.91). No independent predictive factors for reclassification to CD were identified. Conclusions: Therapeutic management of IBDU and UC patients tended to be similar. Two‐thirds of patients remained classified as IBDU.
SN - 0815-9319
SN - 1440-1746
ER -