Patient Age, Sex, and Inflammatory Bowel Disease Phenotype Associate With Course of Primary Sclerosing Cholangitis
| Autor: | Weismueller, T, Strassburg, C, Trivedi, P, Hirschfield, G, Bergquist, A, Said, K, Imam, M, Lazaridis, K, Juran, B, Cheung, A, Lindor, K, Lenzen, H, Manns, M, Ponsioen, C, Beuers, U, Holm, K, Naess, S, Karlsen, T, Schrumpf, E, Boberg, K, Gotthardt, D, Rupp, C, Faerkkilae, M, Jokelainen, K, Marschall, H, Benito De Valle, M, Thorburn, D, Saffioti, F, Weersma, R, Fevery, J, Mueller, T, Chazouillãres, O, Schulze, K, Schramm, C, Almer, S, Pereira, S, Levy, C, Mason, A, Bowlus, C, Floreani, A, Halilbasic, E, Trauner, M, Yimam, K, Milkiewicz, P, Huynh, D, Pares, A, Manser, C, Dalekos, G, Eksteen, B, INVERNIZZI, PIETRO, Berg, C, Kirchner, G, Sarrazin, C, Zimmer, V, Fabris, L, Braun, F, Marzioni, M, Chapman, R, Hansen, B, Hansen, B. |
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| Přispěvatelé: | AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, Gastroenterology and Hepatology, Weismueller, T, Strassburg, C, Trivedi, P, Hirschfield, G, Bergquist, A, Said, K, Imam, M, Lazaridis, K, Juran, B, Cheung, A, Lindor, K, Lenzen, H, Manns, M, Ponsioen, C, Beuers, U, Holm, K, Naess, S, Karlsen, T, Schrumpf, E, Boberg, K, Gotthardt, D, Rupp, C, Faerkkilae, M, Jokelainen, K, Marschall, H, Benito De Valle, M, Thorburn, D, Saffioti, F, Weersma, R, Fevery, J, Mueller, T, Chazouillãres, O, Schulze, K, Schramm, C, Almer, S, Pereira, S, Levy, C, Mason, A, Bowlus, C, Floreani, A, Halilbasic, E, Trauner, M, Yimam, K, Milkiewicz, P, Huynh, D, Pares, A, Manser, C, Dalekos, G, Eksteen, B, Invernizzi, P, Berg, C, Kirchner, G, Sarrazin, C, Zimmer, V, Fabris, L, Braun, F, Marzioni, M, Chapman, R, Hansen, B, Clinicum, Department of Medicine, Gastroenterologian yksikkö, HUS Abdominal Center, Universitat de Barcelona, Gastroenterology & Hepatology, Groningen Institute for Gastro Intestinal Genetics and Immunology (3GI) |
| Rok vydání: | 2017 |
| Předmět: |
Male
Risk Stratification Time Factors Cholangitis POPULATION-BASED COHORT Ulcerative Kaplan-Meier Estimate Gastroenterology Inflammatory bowel disease Sclerosing 0302 clinical medicine Crohn Disease Retrospective Studie MED/12 - GASTROENTEROLOGIA Risk Factors Autoimmune Liver Disease Multivariate Analysi Crohn's disease Cholestasis Incidence Hazard ratio Immune-Mediated Liver Disease Adult Age Distribution Australia Chi-Square Distribution Cholangitis Sclerosing Colitis Ulcerative Disease Progression Europe Female Humans Liver Transplantation Middle Aged Multivariate Analysis North America Phenotype Prognosis Proportional Hazards Models Retrospective Studies Risk Assessment Sex Distribution Young Adult Colitis Ulcerative colitis Inflamació CROHNS-DISEASE 3. Good health ULCERATIVE-COLITIS Cholestasi 030220 oncology & carcinogenesis 030211 gastroenterology & hepatology Human medicine.medical_specialty Time Factor Prognosi Lower risk Article Primary sclerosing cholangitis 03 medical and health sciences Colitis ulcerosa Internal medicine medicine GENOME-WIDE ASSOCIATION PRIMARY BILIARY-CIRRHOSIS Inflammation Hepatology business.industry Proportional hazards model Risk Factor CLINICAL PRESENTATION Retrospective cohort study DOSE URSODEOXYCHOLIC ACID NATURAL-HISTORY medicine.disease digestive system diseases 3121 General medicine internal medicine and other clinical medicine RISK-FACTORS Proportional Hazards Model business SINGLE-CENTER |
| Zdroj: | Gastroenterology, 152(8), 1975-1984.e8. W.B. Saunders Ltd Recercat. Dipósit de la Recerca de Catalunya instname Dipòsit Digital de la UB Universidad de Barcelona Gastroenterology, 152(8), 1975-+. W.B. Saunders Gastroenterology, 152(8), 1975-1984. W B SAUNDERS CO-ELSEVIER INC |
| ISSN: | 1528-0012 0016-5085 |
| Popis: | BACKGROUND & AIMS: Primary sclerosing cholangitis (PSC) is an orphan hepatobiliary disorder associated with inflammatory bowel disease (IBD). We aimed to estimate the risk of disease progression based on distinct clinical phenotypes in a large international cohort of patients with PSC. METHODS: We performed a retrospective outcome analysis of patients diagnosed with PSC from 1980 through 2010 at 37 centers in Europe, North America, and Australia. For each patient, we collected data on sex, clinician-reported age at and date of PSC and IBD diagnoses, phenotypes of IBD and PSC, and date and indication of IBD-related surgeries. The primary and secondary endpoints were liver transplantation or death (LTD) and hepatopancreatobiliary malignancy, respectively. Cox proportional hazards models were applied to determine the effects of individual covariates on rates of clinical events, with time-to-event analysis ascertained through Kaplan-Meier estimates. RESULTS: Of the 7121 patients in the cohort, 2616 met the primary endpoint (median time to event of 14.5 years) and 721 developed hepatopancreatobiliary malignancy. The most common malignancy was cholangiocarcinoma (n = 594); patients of advanced age at diagnosis had an increased incidence compared with younger patients (incidence rate: 1.2 per 100 patient-years for patients younger than 20 years old, 6.0 per 100 patient-years for patients 21-30 years old, 9.0 per 100 patient-years for patients 31-40 years old, 14.0 per 100 patient-years for patients 4150 years old, 15.2 per 100 patient-years for patients 51-60 years old, and 21.0 per 100 patient-years for patients older than 60 years). Of all patients with PSC studied, 65.5% were men, 89.8% had classical or large-duct disease, and 70.0% developed IBD at some point. Assessing the development of IBD as a time-dependent covariate, Crohn's disease and no IBD (both vs ulcerative colitis) were associated with a lower risk of LTD (unadjusted hazard ratio [HR], 0.62; P |
| Databáze: | OpenAIRE |
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