BACKGROUND & AIMS: We investigated the association between the severity of primary sclerosing cholangitis (PSC) and clinical outcomes of patients with ulcerative colitis (UC) on the basis of need for colectomy. METHODS: We analyzed data from 167 patients with PSC and UC who were followed from 1985 to 2011. Patients with PSC and UC were divided into groups that received orthotopic liver transplantation (OLT) (n = 86) or did not (non-OLT, n = 81). Clinical and demographic variables were obtained, and patients were followed until they received OLT or the date of their last clinical visit. RESULTS: The OLT group had significantly more subjects with less severe symptoms of UC (59, 68.6%) than the non-OLT group (12, 14.8%; P < .001). The subjects in the OLT group had a median of 0 UC flares compared with 3 in the non-OLT group (P < .001); fewer subjects in the OLT group required use of azathioprine or mercaptopurine (1, 1.2%), compared with the non-OLT group (14, 17.3%; P = .006). More subjects in the non-OLT group required colectomies (61, 75.3%) than in the OLT group (23, 26.7%; P < .001). On the basis of Cox regression analysis, OLT for PSC independently reduces the need for colectomy (hazard ratio [HR], 0.43; 95% confidence interval [CI], 0.25-0.75; P = .003), as does a high Mayo risk score at diagnosis (HR, 0.52; 95% CI, 0.37-0.72; P < .001). Development of colon neoplasia increased the risk for colectomy (HR, 2.47; 95% CI, 1.63-3.75; P < .001). CONCLUSIONS: Severe progressive PSC that requires liver transplantation appears to reduce the disease activity of UC and the need for colectomy.
BACKGROUND & AIMS: We investigated the association between the severity of primary sclerosing cholangitis (PSC) and clinical outcomes of patients with ulcerative colitis (UC) on the basis of need for colectomy. METHODS: We analyzed data from 167 patients with PSC and UC who were followed from 1985 to 2011. Patients with PSC and UC were divided into groups that received orthotopic liver transplantation (OLT) (n = 86) or did not (non-OLT, n = 81). Clinical and demographic variables were obtained, and patients were followed until they received OLT or the date of their last clinical visit. RESULTS: The OLT group had significantly more subjects with less severe symptoms of UC (59, 68.6%) than the non-OLT group (12, 14.8%; P < .001). The subjects in the OLT group had a median of 0 UC flares compared with 3 in the non-OLT group (P < .001); fewer subjects in the OLT group required use of azathioprine or mercaptopurine (1, 1.2%), compared with the non-OLT group (14, 17.3%; P = .006). More subjects in the non-OLT group required colectomies (61, 75.3%) than in the OLT group (23, 26.7%; P < .001). On the basis of Cox regression analysis, OLT for PSC independently reduces the need for colectomy (hazard ratio [HR], 0.43; 95% confidence interval [CI], 0.25-0.75; P = .003), as does a high Mayo risk score at diagnosis (HR, 0.52; 95% CI, 0.37-0.72; P < .001). Development of colon neoplasia increased the risk for colectomy (HR, 2.47; 95% CI, 1.63-3.75; P < .001). CONCLUSIONS: Severe progressive PSC that requires liver transplantation appears to reduce the disease activity of UC and the need for colectomy.
Authors: G Conway; G Velonias; E Andrews; J J Garber; V Yajnik; A N Ananthakrishnan Journal: Aliment Pharmacol Ther Date: 2017-01-20 Impact factor: 8.171
Authors: Bettina M Buchholz; Panagis M Lykoudis; Reena Ravikumar; Joerg M Pollok; Giuseppe K Fusai Journal: World J Gastroenterol Date: 2018-07-28 Impact factor: 5.742
Authors: María Rojas-Feria; Manuel Castro; Emilio Suárez; Javier Ampuero; Manuel Romero-Gómez Journal: World J Gastroenterol Date: 2013-11-14 Impact factor: 5.742
Authors: John E Eaton; Jayant A Talwalkar; Konstantinos N Lazaridis; Gregory J Gores; Keith D Lindor Journal: Gastroenterology Date: 2013-07-01 Impact factor: 22.682
Authors: Ashwin N Ananthakrishnan; Andrew Cagan; Vivian S Gainer; Su-Chun Cheng; Tianxi Cai; Peter Szolovits; Stanley Y Shaw; Susanne Churchill; Elizabeth W Karlson; Shawn N Murphy; Isaac Kohane; Katherine P Liao Journal: J Crohns Colitis Date: 2014-02-19 Impact factor: 9.071
Authors: Sombat Treeprasertsuk; Einar Björnsson; Emmanouil Sinakos; Emma Weeding; Keith D Lindor Journal: World J Gastrointest Pharmacol Ther Date: 2013-08-06