BACKGROUND: Patients with PSC and IBD have a high incidence of colonic carcinomas (CRC), and the annual incidence of CRC increases with duration of disease. UDCA treatment has been suggested to reduce colonic dysplasias and carcinomas. AIMS: The annual incidence of colorectal carcinomas after long-term UDCA treatment was studied. METHODS: Patients included in a prospective study on the outcome after ursodeoxycholic acid (UDCA) treatment were evaluated. RESULTS: A total of 120 of 171 PSC patients included had IBD (108 UC and 12 CD). All patients were treated with UDCA for a median time of 6.7 years. Seven patients with PSC and IBD developed a CRC yielding a prevalence of 5.8%. In years 0-3 (n = 120) after the start of UDCA, the annual incidence rate of CRC was 0.62/100 patient years; in years 3-6 (n = 93) it increased to 1.28 and decreased thereafter in years 6-9 (n = 67) to 1.17, then in years 9-12 (n = 42) to 0 and after >12 years (n = 24) it remained 0. In PSC with IBD, Kaplan-Meier estimate of CRC formation increased with time in the first years of treatment and reached a plateau after 9 years; after treatment for ≥ 9 years, no further CRC were observed. CONCLUSION: After the start of UDCA, the annual incidence of CRC increased up to 6 years and subsequently decreased. In PSC with IBD treated with UDCA, most colonic carcinomas develop in the first years after the start of treatment.
BACKGROUND:Patients with PSC and IBD have a high incidence of colonic carcinomas (CRC), and the annual incidence of CRC increases with duration of disease. UDCA treatment has been suggested to reduce colonic dysplasias and carcinomas. AIMS: The annual incidence of colorectal carcinomas after long-term UDCA treatment was studied. METHODS:Patients included in a prospective study on the outcome after ursodeoxycholic acid (UDCA) treatment were evaluated. RESULTS: A total of 120 of 171 PSC patients included had IBD (108 UC and 12 CD). All patients were treated with UDCA for a median time of 6.7 years. Seven patients with PSC and IBD developed a CRC yielding a prevalence of 5.8%. In years 0-3 (n = 120) after the start of UDCA, the annual incidence rate of CRC was 0.62/100 patient years; in years 3-6 (n = 93) it increased to 1.28 and decreased thereafter in years 6-9 (n = 67) to 1.17, then in years 9-12 (n = 42) to 0 and after >12 years (n = 24) it remained 0. In PSC with IBD, Kaplan-Meier estimate of CRC formation increased with time in the first years of treatment and reached a plateau after 9 years; after treatment for ≥ 9 years, no further CRC were observed. CONCLUSION: After the start of UDCA, the annual incidence of CRC increased up to 6 years and subsequently decreased. In PSC with IBD treated with UDCA, most colonic carcinomas develop in the first years after the start of treatment.
Authors: Amaar Ghazale; Suresh T Chari; Lizhi Zhang; Thomas C Smyrk; Naoki Takahashi; Michael J Levy; Mark D Topazian; Jonathan E Clain; Randall K Pearson; Bret T Petersen; Santhi Swaroop Vege; Keith Lindor; Michael B Farnell Journal: Gastroenterology Date: 2007-12-07 Impact factor: 22.682
Authors: Keith D Lindor; Kris V Kowdley; Velimir A C Luketic; M Edwyn Harrison; Timothy McCashland; Alex S Befeler; Denise Harnois; Roberta Jorgensen; Jan Petz; Jill Keach; Jody Mooney; Carol Sargeant; Julie Braaten; Tamara Bernard; Debra King; Ellen Miceli; Jeff Schmoll; Tanya Hoskin; Prabin Thapa; Felicity Enders Journal: Hepatology Date: 2009-09 Impact factor: 17.425
Authors: Susan N Cullen; Christian Rust; Kenneth Fleming; Cathryn Edwards; Ulrich Beuers; Roger W Chapman Journal: J Hepatol Date: 2008-02-14 Impact factor: 25.083
Authors: Jonathan D Hansen; Sonal Kumar; Wai-Kit Lo; David M Poulsen; Umme-Aiman Halai; Kathy C Tater Journal: Dig Dis Sci Date: 2013-07-30 Impact factor: 3.199