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
{"title":"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","authors":"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","doi":"10.1002/ueg2.70058","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Few data are available on the impact of primary sclerosing cholangitis (PSC) on inflammatory bowel disease (IBD).</p><p><strong>Objective: </strong>We conducted a retrospective study using TriNetX to compare the outcomes of patients with IBD and those with concomitant IBD and PSC.</p><p><strong>Methods: </strong>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).</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>In this administrative study of patients with IBD and PSC, concomitant PSC was associated with an increased risk of mortality and hospitalization.</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":""},"PeriodicalIF":6.7000,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Primary Sclerosing Cholangitis Worsens Prognosis in Patients With Inflammatory Bowel Disease: A Propensity-Matched Cohort Study.\",\"authors\":\"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\",\"doi\":\"10.1002/ueg2.70058\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Few data are available on the impact of primary sclerosing cholangitis (PSC) on inflammatory bowel disease (IBD).</p><p><strong>Objective: </strong>We conducted a retrospective study using TriNetX to compare the outcomes of patients with IBD and those with concomitant IBD and PSC.</p><p><strong>Methods: </strong>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).</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>In this administrative study of patients with IBD and PSC, concomitant PSC was associated with an increased risk of mortality and hospitalization.</p>\",\"PeriodicalId\":23444,\"journal\":{\"name\":\"United European Gastroenterology Journal\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":6.7000,\"publicationDate\":\"2025-09-08\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"United European Gastroenterology Journal\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1002/ueg2.70058\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"GASTROENTEROLOGY & HEPATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"United European Gastroenterology Journal","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/ueg2.70058","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
Primary Sclerosing Cholangitis Worsens Prognosis in Patients With Inflammatory Bowel Disease: A Propensity-Matched Cohort Study.
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.
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.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
