Patient Age, Sex, and Inflammatory Bowel Disease Phenotype Associate With Course of Primary Sclerosing Cholangitis

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Weismueller , T J , Trivedi , P J , Bergquist , A , Imam , M , Lenzen , H , Ponsioen , C Y , Holm , K , Gotthardt , D , Färkkilä , M , Marschall , H-U , Thorburn , D , Weersma , R K , Fevery , J , Mueller , T , Chazouilleres , O , Schulze , K , Lazaridis , K N , Almer , S , Pereira , S P , Levy , C , Mason , A , Naess , S , Bowlus , C L , Floreani , A , Halilbasic , E , Yimam , K K , Milkiewicz , P , Beuers , U , Huynh , D K , Pares , A , Manser , C N , Dalekos , G N , Eksteen , B , Invernizzi , P , Berg , C P , Kirchner , G I , Sarrazin , C , Zimmer , V , Fabris , L , Braun , F , Marzioni , M , Juran , B D , Said , K , Rupp , C , Jokelainen , K , de Valle , M B , Saffioti , F , Cheung , A , Trauner , M , Schramm , C & Int PSC Study Grp 2017 , ' Patient Age, Sex, and Inflammatory Bowel Disease Phenotype Associate With Course of Primary Sclerosing Cholangitis ' , Gastroenterology , vol. 152 , no. 8 , pp. 1975-+ . https://doi.org/10.1053/j.gastro.2017.02.038

Title: Patient Age, Sex, and Inflammatory Bowel Disease Phenotype Associate With Course of Primary Sclerosing Cholangitis
Author: Weismueller, Tobias J.; Trivedi, Palak J.; Bergquist, Annika; Imam, Mohamad; Lenzen, Henrike; Ponsioen, Cyriel Y.; Holm, Kristian; Gotthardt, Daniel; Färkkilä, Martti; Marschall, Hanns-Ulrich; Thorburn, Douglas; Weersma, Rinse K.; Fevery, Johan; Mueller, Tobias; Chazouilleres, Olivier; Schulze, Kornelius; Lazaridis, Konstantinos N.; Almer, Sven; Pereira, Stephen P.; Levy, Cynthia; Mason, Andrew; Naess, Sigrid; Bowlus, Christopher L.; Floreani, Annarosa; Halilbasic, Emina; Yimam, Kidist K.; Milkiewicz, Piotr; Beuers, Ulrich; Huynh, Dep K.; Pares, Albert; Manser, Christine N.; Dalekos, George N.; Eksteen, Bertus; Invernizzi, Pietro; Berg, Christoph P.; Kirchner, Gabi I.; Sarrazin, Christoph; Zimmer, Vincent; Fabris, Luca; Braun, Felix; Marzioni, Marco; Juran, Brian D.; Said, Karouk; Rupp, Christian; Jokelainen, Kalle; de Valle, Maria Benito; Saffioti, Francesca; Cheung, Angela; Trauner, Michael; Schramm, Christoph; Int PSC Study Grp
Contributor: University of Helsinki, Clinicum
University of Helsinki, Gastroenterologian yksikkö
Date: 2017-06
Language: eng
Number of pages: 18
Belongs to series: Gastroenterology
ISSN: 0016-5085
URI: http://hdl.handle.net/10138/237011
Abstract: BACKGROUND & AIMS: Primary sclerosing cholangitis (PSC) is an orphan hepatobiliary disorder associated with inflammatory bowel disease (IBD). We aimed to estimate the risk of disease progression based on distinct clinical phenotypes in a large international cohort of patients with PSC. METHODS: We performed a retrospective outcome analysis of patients diagnosed with PSC from 1980 through 2010 at 37 centers in Europe, North America, and Australia. For each patient, we collected data on sex, clinician-reported age at and date of PSC and IBD diagnoses, phenotypes of IBD and PSC, and date and indication of IBD-related surgeries. The primary and secondary endpoints were liver transplantation or death (LTD) and hepatopancreatobiliary malignancy, respectively. Cox proportional hazards models were applied to determine the effects of individual covariates on rates of clinical events, with time-to-event analysis ascertained through Kaplan-Meier estimates. RESULTS: Of the 7121 patients in the cohort, 2616 met the primary endpoint (median time to event of 14.5 years) and 721 developed hepatopancreatobiliary malignancy. The most common malignancy was cholangiocarcinoma (n = 594); patients of advanced age at diagnosis had an increased incidence compared with younger patients (incidence rate: 1.2 per 100 patient-years for patients younger than 20 years old, 6.0 per 100 patient-years for patients 21-30 years old, 9.0 per 100 patient-years for patients 31-40 years old, 14.0 per 100 patient-years for patients 4150 years old, 15.2 per 100 patient-years for patients 51-60 years old, and 21.0 per 100 patient-years for patients older than 60 years). Of all patients with PSC studied, 65.5% were men, 89.8% had classical or large-duct disease, and 70.0% developed IBD at some point. Assessing the development of IBD as a time-dependent covariate, Crohn's disease and no IBD (both vs ulcerative colitis) were associated with a lower risk of LTD (unadjusted hazard ratio [HR], 0.62; P
Subject: Risk Stratification
Immune-Mediated Liver Disease
Autoimmune Liver Disease
Cholestasis
DOSE URSODEOXYCHOLIC ACID
PRIMARY BILIARY-CIRRHOSIS
GENOME-WIDE ASSOCIATION
POPULATION-BASED COHORT
ULCERATIVE-COLITIS
NATURAL-HISTORY
RISK-FACTORS
CLINICAL PRESENTATION
CROHNS-DISEASE
SINGLE-CENTER
3121 Internal medicine
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