Dana Duricova1, Ariane Leroyer1, Guillaume Savoye2, Hélène Sarter1,3, Benjamin Pariente4, Djamila Aoucheta5, Laura Armengol-Debeir2, Delphine Ley3,6, Dominique Turck3,6, Laurent Peyrin-Biroulet7, Corinne Gower-Rousseau1,3, Mathurin Fumery3,8. 1. Public Health, Epidemiology and Economic Health, Registre EPIMAD, Lille University and Hospital, Lille, France. 2. Gastroenterology Unit, EPIMAD Registry, Rouen University Hospital, Rouen, France. 3. Lille Inflammation Research International Center LIRIC-UMR 995 Inserm Lille 2 University, Lille, France. 4. Gastroenterology Unit, Hôpital Huriez, Lille University Hospital, Lille, France. 5. Associated Medical Director, Immunology, MSD France, Courbevoie cedex, France. 6. Division of Gastroenterology, Hepatology and Nutrition, Lille University Jeanne de Flandre Children's Hospital, University of Lille, Lille, France. 7. Gastroenterology Unit, Inserm U954, Nancy University and Hospital, Nancy, France. 8. Gastroenterology Unit, EPIMAD Registry, Amiens University Hospital, Amiens, France.
Abstract
BACKGROUND AND AIMS: Data on extra-intestinal manifestations [EIM] and their impact on the disease course of ulcerative colitis [UC] in population-based cohorts are scarce, particularly in paediatric- and elderly-onset UC patients. The aims of this population-based study were to assess: 1] the occurrence of EIM in paediatric- and elderly-onset UC; 2] the factors associated with EIM; and 3] their impact on long-term disease outcome. METHODS: Paediatric-onset [< 17 years at diagnosis] and elderly-onset UC patients [> 60 years at diagnosis] from a French prospective population-based registry [EPIMAD] were included. Data on EIM and other clinical factors at diagnosis and at maximal follow-up were collected. RESULTS: In all, 158 paediatric- and 470 elderly-onset patients were included [median age at diagnosis 14.5 and 68.8 years, median follow-up 11.2 and 6.2 years, respectively]. EIM occurred in 8.9% of childhood- and 3% of elderly-onset patients at diagnosis and in 16.7% and 2.2% of individuals during follow-up [p < 0.01], respectively. The most frequent EIM was joint involvement [15.8% of paediatric onset and 2.6% of elderly-onset]. Presence of EIM at diagnosis was associated with more severe disease course [need for immunosuppressants or biologic therapy or colectomy] in both paediatric- and elderly-onset UC (hazard ratio [HR] = 2.0, 95% confidence interval [CI]: 1.0-4.2; and HR = 2.8, 0.9-7.9, respectively). Extensive colitis was another independent risk factor in both age groups. CONCLUSIONS: Elderly-onset UC patients had lower risk of EIM either at diagnosis or during follow-up than paediatric-onset individuals. EIM at diagnosis predicted more severe disease outcome, including need for immunosuppressive or biologic therapy or surgery, in both paediatric- and elderly-onset UC.
BACKGROUND AND AIMS: Data on extra-intestinal manifestations [EIM] and their impact on the disease course of ulcerative colitis [UC] in population-based cohorts are scarce, particularly in paediatric- and elderly-onset UC patients. The aims of this population-based study were to assess: 1] the occurrence of EIM in paediatric- and elderly-onset UC; 2] the factors associated with EIM; and 3] their impact on long-term disease outcome. METHODS: Paediatric-onset [< 17 years at diagnosis] and elderly-onset UC patients [> 60 years at diagnosis] from a French prospective population-based registry [EPIMAD] were included. Data on EIM and other clinical factors at diagnosis and at maximal follow-up were collected. RESULTS: In all, 158 paediatric- and 470 elderly-onset patients were included [median age at diagnosis 14.5 and 68.8 years, median follow-up 11.2 and 6.2 years, respectively]. EIM occurred in 8.9% of childhood- and 3% of elderly-onset patients at diagnosis and in 16.7% and 2.2% of individuals during follow-up [p < 0.01], respectively. The most frequent EIM was joint involvement [15.8% of paediatric onset and 2.6% of elderly-onset]. Presence of EIM at diagnosis was associated with more severe disease course [need for immunosuppressants or biologic therapy or colectomy] in both paediatric- and elderly-onset UC (hazard ratio [HR] = 2.0, 95% confidence interval [CI]: 1.0-4.2; and HR = 2.8, 0.9-7.9, respectively). Extensive colitis was another independent risk factor in both age groups. CONCLUSIONS: Elderly-onset UC patients had lower risk of EIM either at diagnosis or during follow-up than paediatric-onset individuals. EIM at diagnosis predicted more severe disease outcome, including need for immunosuppressive or biologic therapy or surgery, in both paediatric- and elderly-onset UC.
Authors: M J García; M Pascual; C Del Pozo; A Díaz-González; B Castro; L Rasines; J Crespo; M Rivero Journal: Sci Rep Date: 2020-07-01 Impact factor: 4.379
Authors: Hyo-Jeong Jang; Hyo Rim Suh; Sujin Choi; Suk Jin Hong; Seung-Man Cho; Kwang-Hae Choi; Byung-Ho Choe; Ben Kang Journal: J Korean Med Sci Date: 2021-11-15 Impact factor: 2.153