Primary Sclerosing Cholangitis Worsens Prognosis in Patients With Inflammatory Bowel Disease: A Propensity-Matched Cohort Study.

IF 6.7 2区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

United European Gastroenterology Journal Pub Date : 2025-09-08 DOI:10.1002/ueg2.70058

Ferdinando D'Amico, Mariangela Allocca, Francesca Lusetti, Tommaso Lorenzo Parigi, Francesca Rusconi, Gema Hernandez, Alba Segovia-Hilara, Virginia Solitano, Alessandra Zilli, Federica Furfaro, Gionata Fiorino, Pietro Invernizzi, Laurent Peyrin-Biroulet, Vipul Jairath, Silvio Danese

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引用次数: 0

Abstract

Background: Few data are available on the impact of primary sclerosing cholangitis (PSC) on inflammatory bowel disease (IBD).

Objective: We conducted a retrospective study using TriNetX to compare the outcomes of patients with IBD and those with concomitant IBD and PSC.

Methods: All patients with a confirmed diagnosis of Crohn's disease (CD), ulcerative colitis (UC), or indeterminate colitis with or without PSC were eligible. One-to-one propensity score matching was employed to balance demographic parameters, comorbid conditions, and IBD medications between cohort 1 (IBD) and cohort 2 (IBD and concomitant PSC). The primary endpoint was a composite endpoint including the risk of mortality, hospitalization, and surgery. Risks were expressed as Hazard Ratio (HR) with a 95% confidence interval (CI).

Results: A total of 398,980 IBD patients were analyzed (cohort 1: 395,874 and cohort 2: 3106). After propensity-score-matching, 3007 patients from each group were included (mean age 48.1 ± 19.4 years, female 40%, UC 75% CD 24.8%). Approximately 1%-2% of patients were treated with advanced therapies. Cohort 2 patients had a higher risk of experiencing the composite endpoint compared to cohort 1 group (HR:1.32, 95%CI:1.23-1.42). Similarly, a higher risk of hospitalization and mortality was identified in subjects with IBD and concomitant PSC (HR:1.32, 95% CI: 1.22-1.43 and HR: 1.69, 95%CI: 1.46-1.96). Both CD and UC patients with concomitant PSC had a higher risk of achieving the composite endpoint (HR: 1.18, 95%CI: 1.02-1.37 and HR: 1.29, 95%CI: 1.18-1.40). An increased risk of mortality and hospitalization was found both in patients with CD (HR: 2.16, 95%CI:1.58-2.95, and 1.20, 95%CI:1.03-1.41) and UC (HR: 1.87, 95%CI: 1.57-2.22 and HR: 1.27, 95%CI:1.16-1.40) and concomitant PSC.

Conclusion: In this administrative study of patients with IBD and PSC, concomitant PSC was associated with an increased risk of mortality and hospitalization.

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原发性硬化性胆管炎恶化炎性肠病患者的预后：一项倾向匹配的队列研究

背景：关于原发性硬化性胆管炎（PSC）对炎症性肠病（IBD）影响的数据很少。目的：我们使用TriNetX进行了一项回顾性研究，比较IBD患者和合并IBD和PSC患者的预后。方法：所有确诊为克罗恩病（CD）、溃疡性结肠炎（UC）或不确定结肠炎伴或不伴PSC的患者均入选。采用一对一倾向评分匹配来平衡队列1 （IBD）和队列2 （IBD和伴发PSC）之间的人口统计学参数、合并症条件和IBD药物。主要终点是一个复合终点，包括死亡、住院和手术风险。风险以风险比（HR）表示，95%置信区间（CI）。结果：共分析了398,980例IBD患者（队列1:395,874，队列2:3106）。经倾向评分匹配后，每组纳入3007例患者（平均年龄48.1±19.4岁，女性40%，UC 75%, CD 24.8%）。大约1%-2%的患者接受了先进的治疗。与队列1组相比，队列2患者经历复合终点的风险更高（HR:1.32, 95%CI:1.23-1.42）。同样，IBD合并PSC的患者住院和死亡风险较高（HR:1.32, 95%CI: 1.22-1.43; HR: 1.69, 95%CI: 1.46-1.96）。合并PSC的CD和UC患者达到复合终点的风险均较高（HR: 1.18, 95%CI: 1.02-1.37; HR: 1.29, 95%CI: 1.18-1.40）。CD （HR: 2.16, 95%CI:1.58-2.95, 1.20, 95%CI:1.03-1.41）和UC （HR: 1.87, 95%CI: 1.57-2.22, HR: 1.27, 95%CI:1.16-1.40）合并PSC患者的死亡和住院风险均增加。结论：在这项IBD合并PSC患者的行政研究中，合并PSC与死亡和住院风险增加相关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

United European Gastroenterology Journal GASTROENTEROLOGY & HEPATOLOGY-

CiteScore

10.50

自引率

13.30%

发文量

147

期刊介绍： United European Gastroenterology Journal (UEG Journal) is the official Journal of the United European Gastroenterology (UEG), a professional non-profit organisation combining all the leading European societies concerned with digestive disease. UEG’s member societies represent over 22,000 specialists working across medicine, surgery, paediatrics, GI oncology and endoscopy, which makes UEG a unique platform for collaboration and the exchange of knowledge.