G Roda1, N Narula2, R Pinotti3, A Skamnelos4, K H Katsanos4, R Ungaro1, J Burisch1, J Torres1, J-F Colombel1. 1. The Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, NY, USA. 2. Division of Gastroenterology, Department of Medicine and Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, ON, Canada. 3. Gustave L. and Janet W. Levy Library, Icahn School of Medicine at Mount Sinai, New York, NY, USA. 4. Division of Gastroenterology, School of Health Sciences, University of Ioannina, Ioannina, Greece.
Abstract
BACKGROUND: Disease extent in ulcerative colitis is one of the major factors determining prognosis over the long-term. Disease extent is dynamic and a proportion of patients presenting with limited disease progress to more extensive forms of disease over time. AIM: To perform a systematic review and meta-analysis of epidemiological studies reporting on extension of ulcerative colitis to determine frequency of disease extension in patients with limited ulcerative colitis at diagnosis. METHODS: We performed a systematic literature search to identify studies on disease extension of ulcerative colitis (UC) and predictors of disease progression. RESULTS: Overall, 41 studies were eligible for systematic review but only 30 for meta-analysis. The overall pooled frequency of UC extension was 22.8% with colonic extension being 17.8% at 5 years and 31% at 10 years. Extension was 17.8% (95% CI 11.2-27.3) from E1 to E3, 27.5% (95% CI 7.6-45.6) from E2 to E3 and 20.8% (95% CI 11.4-26.8) from E1 to E2. Rate of extension was significantly higher in patients younger than 18 years (29.2% (CI 6.4-71.3) compared to older patients (20.2% (CI 13.0-30.1) (P<.0001). Risk of extension was significantly higher in patients from North America (37.8%) than from Europe (19.6%) (P<.0001). CONCLUSIONS: In this meta-analysis, approximately one quarter of patients with limited UC extend over time with most extension occurring during the first 10 years. Rate of extension depends on age at diagnosis and geographic origin. Predicting those at high risk of disease extension from diagnosis could lead to personalised therapeutic strategies.
BACKGROUND: Disease extent in ulcerative colitis is one of the major factors determining prognosis over the long-term. Disease extent is dynamic and a proportion of patients presenting with limited disease progress to more extensive forms of disease over time. AIM: To perform a systematic review and meta-analysis of epidemiological studies reporting on extension of ulcerative colitis to determine frequency of disease extension in patients with limited ulcerative colitis at diagnosis. METHODS: We performed a systematic literature search to identify studies on disease extension of ulcerative colitis (UC) and predictors of disease progression. RESULTS: Overall, 41 studies were eligible for systematic review but only 30 for meta-analysis. The overall pooled frequency of UC extension was 22.8% with colonic extension being 17.8% at 5 years and 31% at 10 years. Extension was 17.8% (95% CI 11.2-27.3) from E1 to E3, 27.5% (95% CI 7.6-45.6) from E2 to E3 and 20.8% (95% CI 11.4-26.8) from E1 to E2. Rate of extension was significantly higher in patients younger than 18 years (29.2% (CI 6.4-71.3) compared to older patients (20.2% (CI 13.0-30.1) (P<.0001). Risk of extension was significantly higher in patients from North America (37.8%) than from Europe (19.6%) (P<.0001). CONCLUSIONS: In this meta-analysis, approximately one quarter of patients with limited UC extend over time with most extension occurring during the first 10 years. Rate of extension depends on age at diagnosis and geographic origin. Predicting those at high risk of disease extension from diagnosis could lead to personalised therapeutic strategies.
Authors: Neeraj Narula; Farhad Peerani; Joseph Meserve; Gursimran Kochhar; Khadija Chaudrey; Justin Hartke; Prianka Chilukuri; Jenna Koliani-Pace; Adam Winters; Leah Katta; Eugenia Shmidt; Robert Hirten; David Faleck; Malav P Parikh; Diana Whitehead; Brigid S Boland; Siddharth Singh; Sashidhar Varma Sagi; Monika Fischer; Shannon Chang; Morris Barocas; Michelle Luo; Karen Lasch; Matthew Bohm; Dana Lukin; Keith Sultan; Arun Swaminath; David Hudesman; Nitin Gupta; Bo Shen; Sunanda Kane; Edward V Loftus; Corey A Siegel; Bruce E Sands; Jean-Frederic Colombel; William J Sandborn; Parambir S Dulai Journal: Am J Gastroenterol Date: 2018-06-27 Impact factor: 10.864
Authors: Carmen Argmann; Minami Tokuyama; Ryan C Ungaro; Ruiqi Huang; Ruixue Hou; Sakteesh Gurunathan; Roman Kosoy; Antonio Di'Narzo; Wenhui Wang; Bojan Losic; Haritz Irizar; Lauren Peters; Aleksandar Stojmirovic; Gabrielle Wei; Phillip H Comella; Mark Curran; Carrie Brodmerkel; Joshua R Friedman; Ke Hao; Eric E Schadt; Jun Zhu; Judy Cho; Noam Harpaz; Marla C Dubinsky; Bruce E Sands; Andrew Kasarskis; Saurabh Mehandru; Jean-Frederic Colombel; Mayte Suárez-Fariñas Journal: Gastroenterology Date: 2021-09-02 Impact factor: 22.682
Authors: Sandro da Costa Ferreira; Lilian Rose Otoboni Aprile; Rogério Serafim Parra; Marley Ribeiro Feitosa; Gleici de Castro da Silva Perdoná; Omar Féres; José Joaquim Ribeiro da Rocha; Luiz Ernesto de Almeida Troncon Journal: Turk J Gastroenterol Date: 2022-04 Impact factor: 1.555