Prevalence and Outcomes of Primary Sclerosing Cholangitis in Inflammatory Bowel Disease: A Multinational Study Across Asia.
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Akiyama Shintaro, Park Sang Hyoung, Baek Ji Eun, Kanai Sachiko, Takahara Naminatsu, Kasuga Ryosuke, Nakamoto Nobuhiro, Takagi Yasuhiro, Shinzaki Shinichiro, Weng Meng-Tzu, Wei Shu-Chen, Fujisawa Toshio, Isayama Hiroyuki, Harindranath Sidharth, Desai Devendra, Liang Jie, Park Daye, Park Soo Jung, Mizuno Suguru, Mochida Satoshi, Lai Karen Hei-Tung, Mak Joyce Wing Yan, Khoo Xin-Hui, Hilmi Ida, Ishikawa Naoki, Gu Yubei, Zhang Hu, Oh Shin Ju, Sano Yasuki, Honzawa Yusuke, Cheng Tsz-Fai, Matsuoka Katsuyoshi, Kim Dong Hyun, Fujima Takeshi, Matsuura Minoru, Kim Kyeong Ok, Jang Byung Ik, Yen Hsu-Heng, Jung Sung-Ae, Suen To-Lam, Ni Yen-Hsuan, Naganuma Makoto
Аннотация
METHODS: This retrospective cohort study included patients with IBD from 25 hospitals in 6 Asian countries. The primary endpoint was the prevalence of PSC in patients with IBD. The secondary endpoints included the incidence of colorectal neoplasia and IBD-related surgery following IBD diagnosis, and the occurrence of cholangiocarcinoma, LT, and death after PSC diagnosis among patients with PSC-IBD. Temporal trends were assessed across 5 diagnostic eras of PSC.
RESULTS: Among 51,314 patients with IBD, 474 had PSC (0.92%), with a prevalence of 1.4% in ulcerative colitis and 0.13% in Crohn's disease. Among 375 Asian patients with PSC-IBD, 9.1% developed colorectal neoplasia, 7.2% developed cholangiocarcinoma, 24% underwent LT, and 16% died. In more recent diagnostic eras, patients presented with fewer symptoms, lower alkaline phosphatase levels, and better liver function scores. The use of magnetic resonance cholangiopancreatography has increased over time. Symptomatic PSC and low serum albumin were significantly associated with a shorter time to LT, which was significantly longer in recent eras (P = .016).
CONCLUSIONS: PSC is less prevalent among Asian patients with IBD than in Western populations. The increased use of magnetic resonance cholangiopancreatography may enable earlier detection, contributing to milder disease severity and improved clinical outcomes in recent years. umin.ac.jp, Number UMIN000054487.