The natural history of newly diagnosed ulcerative colitis in patients with concomitant primary sclerosing cholangitis
Open accessAbstract
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.
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More recent comparisons show similar needs for courses of steroids and treatment with immunomodulators in UC patients with and without PSC.
“More recently the natural history from onset of UC in patients with and without PSC have been compared and similar needs regarding courses of steroids and treatment with immunomodulators were shown.365”
From EASL Clinical Practice Guidelines on sclerosing cholangitis (2022) · cites this paper as [365]
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- Authors
- Khan, N., Trivedi, C., Shah, Y., Cole, E., Lewis, J., & Yang, Y.-X.
- Affiliations
- University of Pennsylvania (US)
- Section of Gastroenterology, Corporal Michael J. Crescenz Medical Center, Pennsylvania, USA
- James J. Peters VA Medical Center (US)
- Children's Hospital of Pittsburgh (US)
- Corresponding author
- Khan, Nabeel
- Venue
- Inflammatory Bowel Diseases
- Publisher
- Oxford University Press (OUP)
- Published
- 2018-04-25
- Volume
- 24
- Issue
- 9
- Pages
- 2062-2067
- ISSN
- 1078-0998 (ISSN-L)
- 1536-4844
- OpenAlex
- W2801709134
- Cited by
- 18
- References
- 26
- Citations by year
- 2026: 4 · 2024: 2 · 2023: 1 · 2022: 1 · 2021: 2 · 2020: 5 · 2019: 3
- FWCI
- 1.53
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- public-domain
- Locations
- Inflammatory Bowel Diseases (publishedVersion, public-domain)
- PubMed (publishedVersion)
- Funders
- Eli Lilly and Company
- Pfizer
- Gilead Sciences
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Inflammatory Bowel Disease
- Health Sciences › Medicine › Hepatology › Liver Diseases and Immunity
- Health Sciences › Medicine › Ophthalmology › Ocular Diseases and Behçet’s Syndrome
- Keywords
- ulcerative colitis, primary sclerosing cholangitis
- MeSH terms
- Adult, Colitis, Ulcerative, Female, Humans, Male, Middle Aged, Regression Analysis, Retrospective Studies, Risk Factors, Severity of Illness Index, Cholangitis, Sclerosing, Proportional Hazards Models, Disease Progression
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