Raising awareness for microscopic colitis: disease course and predictors

A prospective cohort study demonstrated that microscopic colitis (MC) can be a relapsing or chronic disease, hampering patients’ quality-of-life. In addition, the disease course at 1 year appears to be predictive of the further course of the disease. The authors hope that these results create awareness by physicians to inform and follow up patients with this condition properly.

“Not much is known about the long-term disease course of MC,” said Dr Bas Verhaegh (Laurentius Hospital Roermond, the Netherlands) [1]. “Also, predictive markers for disease severity are lacking.” The current PRO-MC collaboration study objectified to address these issues. A web-based registry was used to collect MC incident cases from 14 European countries, followed prospectively for 5 years. The participants were categorised according to disease course: quiescent, sustained clinical remission after treatment, relapsing, or chronically active.

At the time of the study presentation, 422 incident cases of MC had been identified, and 220 cases had completed the 5-year follow-up. The mean age of participants was 63 years, 73% were women, and there was an equal distribution between collagenous colitis and lymphocytic colitis. After 5 years of follow-up, 5% had a quiescent disease course, 55% had sustained clinical remission phenotype, 33% had the relapsing disease course, and 7% had chronically active disease. Dr Verhaegh stressed that the disease course at 1 year appeared predictive of disease course at 5 years: 72% of the participants with a quiescent disease course at 1 year had a quiescent or sustained remission disease course at 5 years. On the other hand, those with a chronic active disease at 1 year had a 58% chance to have the relapsing or chronically active disease course at 5 years (see Figure). “This is something we did not know before, and physicians should use this information in their consultations with patients,” highlighted Dr Verhaegh. The findings also showed that quality of life is especially impaired in patients with a relapsing or chronically active disease course. Finally, oral budesonide was the most applied treatment (24%), followed by loperamide (21%) and bulging agents (15%). Biologic agents were used in less than 2% of the cases.

Figure: Disease course at 1 year predictive of disease course at 5 years [1]



“MC is a relapsing or chronic disease in a large proportion of patients, reducing their quality of life,” concluded Dr Verhaegh. “Hopefully, this study will raise awareness for MC by physicians, health insurance companies, and pharmaceutical companies.”

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   1. Verhaegh B, et al. The disease course of microscopic colitis: a 5-year prospective European incident cohort (PRO-MC collaboration). LB05, UEG Week 2023, 14–17 October, Copenhagen, Denmark.

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Posted on 7 December 20237 December 2023