Post-inflammatory Polyp Burden as a Prognostic Marker of Disease-outcome in Patients with Inflammatory Bowel Disease.

Autor: Ellul P; Division of Gastroenterology, Mater Dei hospital, Malta., Schembri J; Division of Gastroenterology, Mater Dei hospital, Malta., Vella Baldacchino A; Division of Gastroenterology, Mater Dei hospital, Malta., Molnár T; Department of Medicine, Szent-Györgyi Albert Medical School, University of Szeged, Hungary., Resal T; Department of Medicine, Szent-Györgyi Albert Medical School, University of Szeged, Hungary., Allocca M; Gastroenterology and Endoscopy, IRCCS Hospital San Raffaele and University Vita-Salute San Raffaele, Milan, Italy., Furfaro F; Gastroenterology and Endoscopy, IRCCS Hospital San Raffaele and University Vita-Salute San Raffaele, Milan, Italy., Dal Buono A; IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy., Theodoropoulou A; Department of Gastroenterology, Venizeleio General Hospital, Heraklion, Greece., Fragaki M; Department of Gastroenterology, Venizeleio General Hospital, Heraklion, Greece., Tsoukali E; Department of Gastroenterology, GHA 'Evangelismos-Polykliniki', Athens, Greece., Mantzaris GJ; Department of Gastroenterology, GHA 'Evangelismos-Polykliniki', Athens, Greece., Phillips FM; Nottingham University Hospitals NHS Trust, Nottingham, UK., Radford S; Nottingham University Hospitals NHS Trust, Nottingham, UK., Moran G; Nottingham University Hospitals NHS Trust, Nottingham, UK., Gonzalez H; Hull University Teaching Hospitals, Hull, UK., Sebastian S; Hull University Teaching Hospitals, Hull, UK., Fousekis F; Division of Gastroenterology, Department of Internal Medicine, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece., Christodoulou D; Division of Gastroenterology, Department of Internal Medicine, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece., Snir I; Division of Gastroenterology, Rabin Medical Center, Petah Tikva, Israel., Lerner Z; Division of Gastroenterology, Rabin Medical Center, Petah Tikva, Israel., Yanai H; Division of Gastroenterology, Rabin Medical Center, Petah Tikva, Israel., Michalopoulos G; Gastroenterology Department, 'Tzaneion' General Hospital of Piraeus, Greece., Tua J; Division of Gastroenterology, Mater Dei hospital, Malta., Camilleri L; Faculty of Science, University of Malta, Malta., Papamichael K; Center for Inflammatory Bowel Diseases, Division of Gastroenterology, Beth-Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA., Karmiris K; Department of Gastroenterology, Venizeleio General Hospital, Heraklion, Greece., Katsanos K; Division of Gastroenterology, Department of Internal Medicine, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece.
Jazyk: angličtina
Zdroj: Journal of Crohn's & colitis [J Crohns Colitis] 2023 Apr 19; Vol. 17 (4), pp. 489-496.
DOI: 10.1093/ecco-jcc/jjac169
Abstrakt: Background and Aims: Post-inflammatory polyps [PIPs] are considered as indicators of previous episodes of severe inflammation and mucosal ulceration. Inflammatory bowel disease [IBD], namely Crohn's disease [CD] and ulcerative colitis [UC], exhibit a perpetuating, relapsing and remitting pattern, and PIPs are a frequent sequela of chronicity. The aim of this study was to determine whether a high PIP burden is associated with a more severe disease course in patients with IBD.
Methods: This was a multinational, multicentre, retrospective study. IBD patients previously diagnosed with PIPs were retrieved from the endoscopic database of each centre. PIP burden was evaluated and associated with demographic and clinical data as well as factors indicating a more unfavourable disease course.
Results: A total of 504 IBD patients with PIPs were recruited [male: 61.9%]. The mean age at IBD diagnosis was 36.9 [±16.8] years. Most patients [74.8%] were diagnosed with UC. A high PIP burden was present in 53.4% of patients. On multivariable Cox regression analysis, a high PIP burden was independently associated with treatment escalation (hazard ratio [HR] 1.35, 95% confidence interval [CI] 1.04-1.75; p = 0.024), hospitalization [HR 1.90; 95% CI 1.24-2.90; p = 0.003], need for surgery [HR 2.28; 95% CI 1.17-4.44, p = 0.02] and younger age at diagnosis [HR 0.99, 95% CI 0.98-0.99; p = 0.003].
Conclusion: PIP burden was associated with a more severe outcome. Future prospective studies should focus on the characterization of PIP burden as to further risk stratify this patient cohort.
(© The Author(s) 2022. Published by Oxford University Press on behalf of European Crohn’s and Colitis Organisation. All rights reserved. For permissions, please email: journals.permissions@oup.com.)
Databáze: MEDLINE
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