Nabeel Khan1,2, Chinmay Trivedi1, Yash Shah3, Elisabeth Cole4, James Lewis5, Yu-Xiao Yang1,2. 1. Section of Gastroenterology, Corporal Michael J. Crescenz Medical Center, Pennsylvania, USA. 2. Section of Gastroenterology, University of Pennsylvania Perelman School of Medicine, Guardian Drive, PA, USA. 3. Department of Internal Medicine, Icahn School of Medicine at Mount Sinai, James J. Peters VA Medical Center, NY, USA. 4. Children's Hospital of Pittsburgh of UPMC, One Children's Hospital Drive, PA, USA. 5. Section of Gastroenterology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
Abstract
BACKGROUND AND AIMS: Primary sclerosing cholangitis (PSC) is commonly associated with ulcerative colitis (UC). Our aim was to compare the course of disease in patients with UC-PSC and UC alone in a nationwide cohort. METHODS: We conducted a retrospective cohort study among nation-wide Veterans Affairs (VA) patients newly diagnosed with UC to determine the association between PSC status and clinical outcomes related to UC disease course. This study was divided into 2 groups of patients: (1) The incident UC-PSC group and (2) the incident UC-alone group. Follow-up began at the time of index colonoscopy that diagnosed UC and ended at the first occurrence of the respective outcome for the regression analysis of the following censoring events: (1) colectomy, (2) death, (3) end of follow-up, and (4 lost to follow-up. RESULTS: The analysis included 836 UC patients without PSC and 74 UC-PSC patients. In univariate comparisons, PSC patients were more likely to have more extensive UC than those without PSC. In a multivariable Cox regression analysis adjusting for sex, age at UC diagnosis, race, severity of UC, and extent of UC, PSC status was not associated with the risk of colectomy for UC, increased risk of receiving ≥ 2 courses of steroids for UC, or with the risk of receiving immunomodulators for UC. CONCLUSION: UC-PSC patients do not have a more benign disease course than UC patients without PSC. UC-PSC patients may have a modestly increased risk for multiple courses of steroids, which may be mediated by more extensive colonic involvement. Published by Oxford University Press on behalf of Crohn’s & Colitis Foundation 2018.
BACKGROUND AND AIMS: Primary sclerosing cholangitis (PSC) is commonly associated with ulcerative colitis (UC). Our aim was to compare the course of disease in patients with UC-PSC and UC alone in a nationwide cohort. METHODS: We conducted a retrospective cohort study among nation-wide Veterans Affairs (VA) patients newly diagnosed with UC to determine the association between PSC status and clinical outcomes related to UC disease course. This study was divided into 2 groups of patients: (1) The incident UC-PSC group and (2) the incident UC-alone group. Follow-up began at the time of index colonoscopy that diagnosed UC and ended at the first occurrence of the respective outcome for the regression analysis of the following censoring events: (1) colectomy, (2) death, (3) end of follow-up, and (4 lost to follow-up. RESULTS: The analysis included 836 UC patients without PSC and 74 UC-PSCpatients. In univariate comparisons, PSCpatients were more likely to have more extensive UC than those without PSC. In a multivariable Cox regression analysis adjusting for sex, age at UC diagnosis, race, severity of UC, and extent of UC, PSC status was not associated with the risk of colectomy for UC, increased risk of receiving ≥ 2 courses of steroids for UC, or with the risk of receiving immunomodulators for UC. CONCLUSION: UC-PSCpatients do not have a more benign disease course than UC patients without PSC. UC-PSCpatients may have a modestly increased risk for multiple courses of steroids, which may be mediated by more extensive colonic involvement. Published by Oxford University Press on behalf of Crohn’s & Colitis Foundation 2018.
Authors: Ming-Hsi Wang; Omar Y Mousa; Jessica J Friton; Laura E Raffals; Jonathan A Leighton; Shabana F Pasha; Michael F Picco; Kelly C Cushing; Kelly Monroe; Billy D Nix; Rodney D Newberry; William A Faubion Journal: Inflamm Bowel Dis Date: 2020-04-11 Impact factor: 5.325
Authors: Chathyan Pararasa; Na Zhang; Thomas J Tull; Ming H A Chong; Jacqueline H Y Siu; William Guesdon; Konstantia Maria Chavele; Jeremy D Sanderson; Louise Langmead; Klaartje Kok; Jo Spencer; Anna Vossenkamper Journal: Front Immunol Date: 2019-03-05 Impact factor: 7.561