Lancet Regional Health-Europe最新文献

{"title":"Comparing CHA2DS2-VA and CHA2DS2-VASc scores for stroke risk stratification in patients with atrial fibrillation: a temporal trends analysis from the retrospective Finnish AntiCoagulation in Atrial Fibrillation (FinACAF) cohort","authors":"","doi":"10.1016/j.lanepe.2024.100967","DOIUrl":"10.1016/j.lanepe.2024.100967","url":null,"abstract":"<div><h3>Background</h3><p>Contemporary data have shown a decrease in the ischaemic stroke risk associated with female sex in patients with atrial fibrillation (AF). We evaluated temporal trends in the predictive value of a non-sex CHA₂DS₂-VASc risk score (ie. CHA₂DS₂-VA).</p></div><div><h3>Methods</h3><p>The FinACAF study covers all patients with incident AF between 2007 and 2018 in Finland from all levels of care. The CHA₂DS₂-VA score was compared with the CHA₂DS₂-VASc using continuous and category-based net reclassification indices (NRIs), integrated discrimination improvement (IDI), c-statistics and decision curve analyses.</p></div><div><h3>Findings</h3><p>We identified 144,879 anticoagulant naïve patients with new-onset AF between 2007 and 2018 (49.9% women; mean age 72.1 years), of whom 3936 (2.7%) experienced ischaemic stroke during one-year follow-up. Based on both continuous and category-based NRIs, the CHA₂DS₂-VA score was inferior to the CHA₂DS₂-VASc in the early years (−0.333 (95% CI −0.411 to −0.261) and −0.118 (95% CI −0.137 to −0.099), respectively). However, the differences attenuated over time, and by the end of the study period, the continuous NRI became non-significant (−0.093 (95% CI −0.165 to 0.032)), whereas the category-based NRI reversed in favor of the CHA₂DS₂-VA (0.070 (95% CI 0.048–0.087)). The IDI was non-significant in early years (0.0009 (95% CI −0.0024 to 0.0037)), but over time became statistically significant in favor of the CHA₂DS₂-VA score (0.0022 (95% CI 0.0001–0.0044)). The Cox models fitted with the CHA₂DS₂-VA and the CHA₂DS₂-VASc scores exhibited comparable discriminative capability in the beginning of the study (p-value 0.63), but over time marginal differences in favor of the CHA₂DS₂-VA score emerged (p-value 0.0002).</p></div><div><h3>Interpretation</h3><p>In 2007–2008 (when females had higher AF-related stroke risks than males), the CHA₂DS₂-VASc score outperformed the CHA₂DS₂-VA score, but the initial differences between the scores attenuated over time. By the end of the study period in 2017–2018 (with limited/no sex differences in AF-related stroke), there was marginal superiority for the CHA₂DS₂-VA score.</p></div><div><h3>Funding</h3><p>This work was supported by the <span>Aarne Koskelo Foundation</span>, The <span>Finnish Foundation</span> for <span>Cardiovascular Research</span>, The <span>Finnish State Research funding</span>, and <span>Helsinki and Uusimaa Hospital District research fund</span>.</p></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":null,"pages":null},"PeriodicalIF":13.6,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666776224001340/pdfft?md5=c55b1d7633a43f7935482cdac173fcd3&pid=1-s2.0-S2666776224001340-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141410905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transcranial static magnetic stimulation for amyotrophic lateral sclerosis: a bicentric, randomised, double-blind placebo-controlled phase 2 trial","authors":"","doi":"10.1016/j.lanepe.2024.101019","DOIUrl":"10.1016/j.lanepe.2024.101019","url":null,"abstract":"<div><h3>Background</h3><p>Enhanced glutamatergic transmission leading to motor neuron death is considered the major pathophysiological mechanism of amyotrophic lateral sclerosis (ALS). Motor cortex excitability can be suppressed by transcranial static magnetic stimulation (tSMS), thus tSMS can be evaluated as a potential treatment for ALS. The aim of present study was to investigate the efficacy and safety of tSMS in ALS.</p></div><div><h3>Methods</h3><p>In this phase 2 trial, we randomly assigned ALS patients to receive daily tSMS or placebo stimulation over a period of 6 months. For each participant we calculated mean disease monthly progression rate (MPR) as the variation of the total ALS Functional Rating Scale-Revised (ALSRFS-R) score, before the beginning of the treatment (over a period of at least three months) and over the six-month treatment period. The primary efficacy outcome was the difference in MPR before and after the beginning of treatment. Secondary outcomes included safety and tolerability, compliance, and changes in corticospinal output. A long-term follow-up of 18 months was performed in all patients who completed the six-month treatment considering a composite endpoint event (tracheostomy or death). Trial registered at <span><span>ClinicalTrials.gov</span><svg><path></path></svg></span>, ID: <span><span>NCT04393467</span><svg><path></path></svg></span>, status: closed.</p></div><div><h3>Findings</h3><p>Forty participants were randomly assigned to real (n = 21) or placebo stimulation (n = 19). Thirty-two participants (18 real and 14 placebo) completed the 6-month treatment. The MPR did not show statistically significant differences between the two arms during the pre-treatment (mean ± Standard deviation; Real: 1.02 ± 0.62, Sham: 1.02 ± 0.57, p-value = 1.00) and treatment period (Real: 0.90 ± 0.55, Sham: 0.94 ± 0.55, p-value = 0.83). Results for secondary clinical endpoints showed that the treatment is feasible and safe, being compliance with tSMS high. The change in corticospinal output did not differ significantly between the two groups. At the end of the long-term follow-up of 18 months, patients of real group had a statistically significant higher tracheostomy-free survival compared with patients of placebo group (Hazard Ratio = 0.27 95% Confidence interval 0.09–0.80, p-value = 0.019).</p></div><div><h3>Interpretation</h3><p>tSMS did not modify disease progression during the 6 months of treatment. However, long-term follow-up revealed a substantial increase in tracheostomy free survival in patients treated with real stimulation supporting the evaluation of tSMS in larger and more prolonged studies.</p></div><div><h3>Funding</h3><p>The “<span>Fondazione ‘Nicola Irti’ per le opere di carità e di cultura</span>”, Rome, Italy, supported present study.</p></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":null,"pages":null},"PeriodicalIF":13.6,"publicationDate":"2024-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666776224001868/pdfft?md5=36b7d5699ab0729ad52f4cb2b8d113f9&pid=1-s2.0-S2666776224001868-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141951707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Answering the call: co-designing a global trials network for cerebral palsy","authors":"","doi":"10.1016/j.lanepe.2024.101015","DOIUrl":"10.1016/j.lanepe.2024.101015","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":null,"pages":null},"PeriodicalIF":13.6,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666776224001820/pdfft?md5=2183d823986f57b701148c62306603f5&pid=1-s2.0-S2666776224001820-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141953084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to ‘Impact of COVID-19 on immunocompromised populations during the Omicron era: insights from the observational population-based INFORM study’ [The Lancet Regional Health – Europe 35 (2023) 100747]","authors":"","doi":"10.1016/j.lanepe.2024.101008","DOIUrl":"10.1016/j.lanepe.2024.101008","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":null,"pages":null},"PeriodicalIF":13.6,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666776224001753/pdfft?md5=e3ec1f96b688d98c0ed4bbbc240c2e0e&pid=1-s2.0-S2666776224001753-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141952432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic and prognostic biomarkers in immune checkpoint inhibitor-related encephalitis: a retrospective cohort study","authors":"","doi":"10.1016/j.lanepe.2024.101011","DOIUrl":"10.1016/j.lanepe.2024.101011","url":null,"abstract":"<div><h3>Background</h3><p>Immune checkpoint inhibitor-related encephalitis (ICI-encephalitis) is not well characterised and diagnostic and prognostic biomarkers are lacking. We aimed to comprehensively characterise ICI-encephalitis and identify diagnostic biomarkers and outcome predictors.</p></div><div><h3>Methods</h3><p>This retrospective observational study included all patients with ICI-encephalitis studied in the French Reference Centre on Paraneoplastic Neurological Syndromes (PNS) and Autoimmune Encephalitis (2015–2023). ICI encephalitis was considered definite in case of inflammatory findings at paraclinical tests and/or well-characterised neural antibodies. Predictors of immune-related adverse event (irAE) treatment response, defined as a Common Terminology Criteria for Adverse Events v5.0 grade &lt; 3 at any time after therapeutic intervention, were assessed by logistic regression analysis, and predictors of mortality by Cox regression analysis. Neurofilament light chain (NfL) was measured by enzyme-linked immunosorbent assay.</p></div><div><h3>Findings</h3><p>Sixty-seven patients with definite encephalitis were identified (median age, 69 years; 66% male). A focal syndrome was observed in 43/67 patients (64%; limbic encephalitis, cerebellar ataxia, and/or brainstem encephalitis), while 24/67 (36%) had meningoencephalitis, a non-focal syndrome with altered mental status (22/24 patients, 92%) and pleocytosis (24/24 patients, 100%). Patients with focal encephalitis more frequently had abnormal brain MRI (26/42, 62% <em>versus</em> 8/24, 33%, p = 0.025), PNS-related antibodies (36/43, 84% <em>versus</em> 1/24, 4%, p &lt; 0.001), and neuroendocrine cancers (22/43, 51% <em>versus</em> 1/24, 4%; p &lt; 0.001) than patients with meningoencephalitis. Focal encephalitis patients had a lower rate of irAE treatment response (7/39, 18%) and higher mortality (27/43, 63%) compared to meningoencephalitis patients (12/22, 77% and 5/24, 21%, respectively, p &lt; 0.001 each). PNS-related antibodies were associated with less irAE treatment response, independently of age, sex, and baseline severity (adjusted OR 0.05; 95%CI [0.01; 0.19]; p &lt; 0.001) as well as higher mortality, independently of age and cancer type (adjusted HR 5.07; 95% CI [2.12; 12.12]; p &lt; 0.001). Serum NfL discriminated patients with definite ICI-encephalitis (n = 27) from cancer-matched controls (n = 16; optimal cut-off &gt;273.5 pg/mL, sensitivity 81%, specificity 88%, AUC 0.87, 95% CI [0.76; 0.98]) and irAE treatment responders (n = 10) from non-responders (n = 17, optimal cut-off &gt;645 pg/mL, sensitivity 90%, specificity 65%; AUC 0.75, 95% CI [0.55; 0.94]).</p></div><div><h3>Interpretation</h3><p>ICI-encephalitis corresponds to a set of clinically-recognisable syndromes. Patients with focal encephalitis, PNS-related antibodies, and/or higher serum NfL have low irAE treatment response rates. Research is needed on the underlying immunopathogenesis to foster therapeutic innovatio","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":null,"pages":null},"PeriodicalIF":13.6,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666776224001789/pdfft?md5=f80b2927d93655a84328634ecd7bff55&pid=1-s2.0-S2666776224001789-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141952431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of nirsevimab against RSV-bronchiolitis in paediatric ambulatory care: a test-negative case–control study","authors":"","doi":"10.1016/j.lanepe.2024.101007","DOIUrl":"10.1016/j.lanepe.2024.101007","url":null,"abstract":"<div><h3>Background</h3><p>Respiratory syncytial virus (RSV) is the leading cause of lower-respiratory-tract infection in children. Nirsevimab, a monoclonal antibody against RSV, was implemented in a few countries in September 2023. However, its post-license effectiveness in ambulatory care settings is unknown. We aimed to assess the effectiveness of nirsevimab against RSV-bronchiolitis in outpatients aged &lt;12 months.</p></div><div><h3>Methods</h3><p>We conducted a test-negative case–control study based on a national ambulatory surveillance system. We included all infants aged &lt;12 months who had bronchiolitis and results of an RSV rapid antigen test performed, visiting a network of 107 ambulatory paediatricians from September 15, 2023, to February 1, 2024. Case patients were infants with bronchiolitis and a rapid antigen test positive for RSV. Control patients were infants with bronchiolitis and a rapid antigen test negative for RSV. Effectiveness was assessed by a logistic regression model adjusted for potential confounders. A range of sensitivity analyses were conducted to assess the robustness of the findings.</p></div><div><h3>Findings</h3><p>We included 883 outpatients who had bronchiolitis and results of an RSV rapid antigen test (453 were case patients, and 430 were control patients). Overall, 62/453 (13.7%) case patients and 177/430 (41.2%) control patients had been previously immunised for nirsevimab. The adjusted effectiveness of nirsevimab against RSV-bronchiolitis was 79.7% (95% CI 67.7–87.3). Sensitivity analyses gave similar results.</p></div><div><h3>Interpretation</h3><p>This post-license study indicates that nirsevimab was effective in preventing RSV-bronchiolitis in ambulatory care settings.</p></div><div><h3>Funding</h3><p>The study was supported by <span>Association Clinique et Thérapeutique Infantile du Val de Marne</span> (ACTIV), <span>French Pediatrician Ambulatory Association</span> (AFPA) and unrestricted grants from <span>GSK</span>, <span>MSD</span>, <span>Pfizer</span> and <span>Sanofi</span>.</p></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":null,"pages":null},"PeriodicalIF":13.6,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666776224001741/pdfft?md5=223fd7a8a4a2c132835e7494174954a8&pid=1-s2.0-S2666776224001741-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141960896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of a school-based food assistance program on household food insecurity in Greece, 2012–2019: a multi-year evaluation of the DIATROFI program","authors":"","doi":"10.1016/j.lanepe.2024.101004","DOIUrl":"10.1016/j.lanepe.2024.101004","url":null,"abstract":"<div><h3>Background</h3><p>Childhood food insecurity can persist among low socioeconomic areas in high-income countries. Universal Free School Meal (UFSM) programs are designed to respond to this pressing issue. This study aimed to conduct a multi-year evaluation of the DIATROFI Program’s impact on household food insecurity in Greece.</p></div><div><h3>Methods</h3><p>This study utilized data from 18,716 students (618 kindergarten to high schools), from low socioeconomic areas participating in the school-level UFSM Program DIATROFI between 2012 and 2019. Parents of students completed annual baseline and follow-up paper-based self-completed questionnaires. The primary outcome was household food insecurity, measured using the Food Security Survey Module (FSSM) at both questionnaires, and evaluated through mixed linear and logistic regression models with repeated measurements.</p></div><div><h3>Findings</h3><p>Students’ median age was 9 years old (Interquartile range (IQR): 6.5, 12.0), 51.6% (n = 9658) were girls, and 82.2% (n = 15,382) lived in low/medium socioeconomic affluence households. Households with food insecurity reduced from 51.5% (n = 9630) to 47.6% (n = 8901) after one school year. Food insecurity score declined steadily for four years of consecutive participation, compared to baseline score (one-year b:–0.26; 95% Confidence Interval (CI):–0.30, −0.22, and four-year −1.28; −1.53, −1.03). The likelihood of retaining food insecure status reduced from 17% after one-year participation (Odds Ratio (OR): 0.83; 95% CI: 0.79, 0.87) to 36% after four-year participation (0.64; 0.49, 0.82). The Program’s impact on household food insecurity alleviation was greater among households with low parental education and low socioeconomic affluence.</p></div><div><h3>Interpretation</h3><p>The DIATROFI Program effectively improved household food security during and after the Greek socioeconomic crisis. School-level UFSM programs targeting underprivileged students can improve household food insecurity, with a more pronounced effect with increased years of participation, and among economically disadvantaged households.</p></div><div><h3>Funding</h3><p>The DIATROFI Program was funded through various national and private organizations, including national prefecture authorities, Greek payment authorities, philanthropic/charitable organizations, and private companies.</p></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":null,"pages":null},"PeriodicalIF":13.6,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666776224001716/pdfft?md5=b83b02f9658585d27599aed58efdd42c&pid=1-s2.0-S2666776224001716-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141960895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Support for smoke-free generation strategies in Italy","authors":"","doi":"10.1016/j.lanepe.2024.101013","DOIUrl":"10.1016/j.lanepe.2024.101013","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":null,"pages":null},"PeriodicalIF":13.6,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666776224001807/pdfft?md5=a071bf1761361f70a8a5d8c5aba8056a&pid=1-s2.0-S2666776224001807-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141960474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Encouraging mortality trends among the obese population in England, but public health challenges from rising obesity prevalence remain","authors":"","doi":"10.1016/j.lanepe.2024.101014","DOIUrl":"10.1016/j.lanepe.2024.101014","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":null,"pages":null},"PeriodicalIF":13.6,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666776224001819/pdfft?md5=a6e88b34376d78da091f98a8852b2424&pid=1-s2.0-S2666776224001819-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141960473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Past, current, and future trends in the prevalence of primary sclerosing cholangitis and inflammatory bowel disease across England (2015–2027): a nationwide, population-based study","authors":"Hannah Crothers ,&nbsp;James Ferguson ,&nbsp;Mohammed Nabil Quraishi ,&nbsp;Rachel Cooney ,&nbsp;Tariq H. Iqbal ,&nbsp;Palak J. Trivedi","doi":"10.1016/j.lanepe.2024.101002","DOIUrl":"https://doi.org/10.1016/j.lanepe.2024.101002","url":null,"abstract":"<div><h3>Background</h3><p>Primary sclerosing cholangitis (PSC) is one of the leading indications for liver transplantation in Europe, and a major risk factor for cancer in inflammatory bowel disease (IBD). However, it is not known how the epidemiology of PSC will change as that of IBD evolves. The aim of this study is to provide nationwide statistics on the past and current prevalence of PSC and IBD across England, and forecast how this is likely to change over time.</p></div><div><h3>Methods</h3><p>We accessed and analysed a nationwide population-based administrative healthcare registry, which houses prospectively accrued data since April 1st 2001. In so doing, the past and current prevalence of PSC-IBD and IBD alone was determined among 18–60-year-olds in England, alongside average annual percentage change rates (AAPC), between the 1st of January 2015 and 2020. Past and current prevalence data, alongside trends in incidence and event-free survival rates, were then used to forecast future prevalence between 2021 and 2027.</p></div><div><h3>Findings</h3><p>In 2015, the prevalence of PSC with prior IBD diagnosis was 5.0 per 100,000 population, rising to 5.7 when including those with IBD diagnosed after PSC. In 2020, prevalence increased to 7.6 (8.6 accounting for IBD developing after PSC), yielding an AAPC of 8.8. In 2027, PSC-IBD prevalence is forecast to be 11.7 (95% prediction interval [PI]: 10.8–12.7), and 13.3 when accounting for IBD developing after PSC (AAPC: 6.4; 95% PI: 5.3–7.5). Comparatively, the prevalence of IBD alone rose among 18–60-year-olds from 384.3 in 2015 to 538.7 in 2020 (AAPC 7.0), and forecast to increase to 742.5 by 2027 (95% PI: 736.4–748.0; AAPC: 4.7, 95% PI: 4.6–4.8).</p></div><div><h3>Interpretation</h3><p>The rate of growth in PSC-IBD is predicted to exceed IBD-alone. Further research is needed to understand changes in disease epidemiology, including aetiological drivers of developing (invariably progressive) liver disease in IBD, and the implications of rising case burden on health care resources.</p></div><div><h3>Funding</h3><p>This study was supported by an unrestricted grant provided by <span>Gilead Sciences</span>.</p></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":null,"pages":null},"PeriodicalIF":13.6,"publicationDate":"2024-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666776224001698/pdfft?md5=2f086ddbe5a5f36ce2f1b7c18e57898e&pid=1-s2.0-S2666776224001698-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141596685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}