The Impact of Concomitant Ulcerative Colitis on the Clinical Course in Patients with Primary Sclerosing Cholangitis: An Investigation Using a Nationwide Database in Japan
Introoduction: Primary sclerosing cholangitis (PSC) is a rare disease, especially in Asian countries. PSC often develops during ulcerative colitis (UC). Little is known about the severity of PSC in patients with UC. Thus, this study aimed to investigate the impact of concomitant UC on the clinical c...
| Main Authors: | , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Karger Publishers
2023-02-01
|
| Series: | Inflammatory Intestinal Diseases |
| Subjects: | |
| Online Access: | https://www.karger.com/Article/FullText/529338 |
| _version_ | 1797896441894535168 |
|---|---|
| author | Rintaro Moroi Kota Yano Kunio Tarasawa Yusuke Shimoyama Takeo Naito Hisashi Shiga Shin Hamada Yoichi Kakuta Kiyohide Fushimi Kenji Fujimori Yoshitaka Kinouchi Atsushi Masamune |
| author_facet | Rintaro Moroi Kota Yano Kunio Tarasawa Yusuke Shimoyama Takeo Naito Hisashi Shiga Shin Hamada Yoichi Kakuta Kiyohide Fushimi Kenji Fujimori Yoshitaka Kinouchi Atsushi Masamune |
| author_sort | Rintaro Moroi |
| collection | DOAJ |
| description | Introoduction: Primary sclerosing cholangitis (PSC) is a rare disease, especially in Asian countries. PSC often develops during ulcerative colitis (UC). Little is known about the severity of PSC in patients with UC. Thus, this study aimed to investigate the impact of concomitant UC on the clinical course of patients with PSC using a nationwide database in Japan. Methods: We collected data on patients who were admitted for PSC using a nationwide database and divided eligible admissions according to concomitant UC (PSC-UC group vs. PSC-alone group). We conducted propensity score matching and compared the rates of liver transplantation, biliary drainage, and other clinical events between the two groups. We also conducted a multivariate analysis to identify the clinical factors that affect biliary drainage, cholangiocarcinoma, and liver transplantation. Results: We enrolled 672 patients after propensity score matching. The rate of liver transplantation in the PSC-UC group was lower than that in the PSC-alone group (2.2 vs. 5.4%, p = 0.002), whereas the rate of biliary drainage did not differ between the two groups (38.1 vs. 33.8%, p = 0.10). On multivariate analysis, concomitant UC was identified as a clinical factor that decreased the risk of liver transplantation (odds ratio = 0.40, 95% confidence interval: 0.23–0.68, p = 0.0007). Discussion: Concomitant UC in patients with PSC may decrease the risk of liver transplantation. The milder disease activity of PSC with UC is more likely compared to that of PSC without UC. |
| first_indexed | 2024-04-10T07:41:49Z |
| format | Article |
| id | doaj.art-0c0de4a457de48cb837c28f562d38625 |
| institution | Directory Open Access Journal |
| issn | 2296-9403 2296-9365 |
| language | English |
| last_indexed | 2024-04-10T07:41:49Z |
| publishDate | 2023-02-01 |
| publisher | Karger Publishers |
| record_format | Article |
| series | Inflammatory Intestinal Diseases |
| spelling | doaj.art-0c0de4a457de48cb837c28f562d386252023-02-23T11:31:01ZengKarger PublishersInflammatory Intestinal Diseases2296-94032296-93652023-02-011810.1159/000529338529338The Impact of Concomitant Ulcerative Colitis on the Clinical Course in Patients with Primary Sclerosing Cholangitis: An Investigation Using a Nationwide Database in JapanRintaro Moroi0https://orcid.org/0000-0002-6759-0135Kota Yano1Kunio Tarasawa2Yusuke Shimoyama3Takeo Naito4Hisashi Shiga5https://orcid.org/0000-0001-6623-2603Shin Hamada6Yoichi Kakuta7https://orcid.org/0000-0002-7042-009XKiyohide Fushimi8https://orcid.org/0000-0002-1894-0290Kenji Fujimori9https://orcid.org/0000-0003-2199-7172Yoshitaka Kinouchi10Atsushi Masamune11https://orcid.org/0000-0001-7184-7282Division of Gastroenterology, Tohoku University Hospital, Sendai, JapanDivision of Gastroenterology, Tohoku University Hospital, Sendai, JapanDepartment of Health Administration and Policy, Tohoku University Graduate School of Medicine, Sendai, JapanDivision of Gastroenterology, Tohoku University Hospital, Sendai, JapanDivision of Gastroenterology, Tohoku University Hospital, Sendai, JapanDivision of Gastroenterology, Tohoku University Hospital, Sendai, JapanDivision of Gastroenterology, Tohoku University Hospital, Sendai, JapanDivision of Gastroenterology, Tohoku University Hospital, Sendai, JapanDepartment of Health Policy and Informatics, Tokyo Medical and Dental University Graduate School of Medicine, Bunkyo, JapanDepartment of Health Administration and Policy, Tohoku University Graduate School of Medicine, Sendai, JapanDivision of Gastroenterology, Tohoku University Hospital, Sendai, JapanDivision of Gastroenterology, Tohoku University Hospital, Sendai, JapanIntrooduction: Primary sclerosing cholangitis (PSC) is a rare disease, especially in Asian countries. PSC often develops during ulcerative colitis (UC). Little is known about the severity of PSC in patients with UC. Thus, this study aimed to investigate the impact of concomitant UC on the clinical course of patients with PSC using a nationwide database in Japan. Methods: We collected data on patients who were admitted for PSC using a nationwide database and divided eligible admissions according to concomitant UC (PSC-UC group vs. PSC-alone group). We conducted propensity score matching and compared the rates of liver transplantation, biliary drainage, and other clinical events between the two groups. We also conducted a multivariate analysis to identify the clinical factors that affect biliary drainage, cholangiocarcinoma, and liver transplantation. Results: We enrolled 672 patients after propensity score matching. The rate of liver transplantation in the PSC-UC group was lower than that in the PSC-alone group (2.2 vs. 5.4%, p = 0.002), whereas the rate of biliary drainage did not differ between the two groups (38.1 vs. 33.8%, p = 0.10). On multivariate analysis, concomitant UC was identified as a clinical factor that decreased the risk of liver transplantation (odds ratio = 0.40, 95% confidence interval: 0.23–0.68, p = 0.0007). Discussion: Concomitant UC in patients with PSC may decrease the risk of liver transplantation. The milder disease activity of PSC with UC is more likely compared to that of PSC without UC.https://www.karger.com/Article/FullText/529338ulcerative colitisprimary sclerosing cholangitisliver transplantationbiliary drainagecholangiocarcinoma |
| spellingShingle | Rintaro Moroi Kota Yano Kunio Tarasawa Yusuke Shimoyama Takeo Naito Hisashi Shiga Shin Hamada Yoichi Kakuta Kiyohide Fushimi Kenji Fujimori Yoshitaka Kinouchi Atsushi Masamune The Impact of Concomitant Ulcerative Colitis on the Clinical Course in Patients with Primary Sclerosing Cholangitis: An Investigation Using a Nationwide Database in Japan Inflammatory Intestinal Diseases ulcerative colitis primary sclerosing cholangitis liver transplantation biliary drainage cholangiocarcinoma |
| title | The Impact of Concomitant Ulcerative Colitis on the Clinical Course in Patients with Primary Sclerosing Cholangitis: An Investigation Using a Nationwide Database in Japan |
| title_full | The Impact of Concomitant Ulcerative Colitis on the Clinical Course in Patients with Primary Sclerosing Cholangitis: An Investigation Using a Nationwide Database in Japan |
| title_fullStr | The Impact of Concomitant Ulcerative Colitis on the Clinical Course in Patients with Primary Sclerosing Cholangitis: An Investigation Using a Nationwide Database in Japan |
| title_full_unstemmed | The Impact of Concomitant Ulcerative Colitis on the Clinical Course in Patients with Primary Sclerosing Cholangitis: An Investigation Using a Nationwide Database in Japan |
| title_short | The Impact of Concomitant Ulcerative Colitis on the Clinical Course in Patients with Primary Sclerosing Cholangitis: An Investigation Using a Nationwide Database in Japan |
| title_sort | impact of concomitant ulcerative colitis on the clinical course in patients with primary sclerosing cholangitis an investigation using a nationwide database in japan |
| topic | ulcerative colitis primary sclerosing cholangitis liver transplantation biliary drainage cholangiocarcinoma |
| url | https://www.karger.com/Article/FullText/529338 |
| work_keys_str_mv | AT rintaromoroi theimpactofconcomitantulcerativecolitisontheclinicalcourseinpatientswithprimarysclerosingcholangitisaninvestigationusinganationwidedatabaseinjapan AT kotayano theimpactofconcomitantulcerativecolitisontheclinicalcourseinpatientswithprimarysclerosingcholangitisaninvestigationusinganationwidedatabaseinjapan AT kuniotarasawa theimpactofconcomitantulcerativecolitisontheclinicalcourseinpatientswithprimarysclerosingcholangitisaninvestigationusinganationwidedatabaseinjapan AT yusukeshimoyama theimpactofconcomitantulcerativecolitisontheclinicalcourseinpatientswithprimarysclerosingcholangitisaninvestigationusinganationwidedatabaseinjapan AT takeonaito theimpactofconcomitantulcerativecolitisontheclinicalcourseinpatientswithprimarysclerosingcholangitisaninvestigationusinganationwidedatabaseinjapan AT hisashishiga theimpactofconcomitantulcerativecolitisontheclinicalcourseinpatientswithprimarysclerosingcholangitisaninvestigationusinganationwidedatabaseinjapan AT shinhamada theimpactofconcomitantulcerativecolitisontheclinicalcourseinpatientswithprimarysclerosingcholangitisaninvestigationusinganationwidedatabaseinjapan AT yoichikakuta theimpactofconcomitantulcerativecolitisontheclinicalcourseinpatientswithprimarysclerosingcholangitisaninvestigationusinganationwidedatabaseinjapan AT kiyohidefushimi theimpactofconcomitantulcerativecolitisontheclinicalcourseinpatientswithprimarysclerosingcholangitisaninvestigationusinganationwidedatabaseinjapan AT kenjifujimori theimpactofconcomitantulcerativecolitisontheclinicalcourseinpatientswithprimarysclerosingcholangitisaninvestigationusinganationwidedatabaseinjapan AT yoshitakakinouchi theimpactofconcomitantulcerativecolitisontheclinicalcourseinpatientswithprimarysclerosingcholangitisaninvestigationusinganationwidedatabaseinjapan AT atsushimasamune theimpactofconcomitantulcerativecolitisontheclinicalcourseinpatientswithprimarysclerosingcholangitisaninvestigationusinganationwidedatabaseinjapan AT rintaromoroi impactofconcomitantulcerativecolitisontheclinicalcourseinpatientswithprimarysclerosingcholangitisaninvestigationusinganationwidedatabaseinjapan AT kotayano impactofconcomitantulcerativecolitisontheclinicalcourseinpatientswithprimarysclerosingcholangitisaninvestigationusinganationwidedatabaseinjapan AT kuniotarasawa impactofconcomitantulcerativecolitisontheclinicalcourseinpatientswithprimarysclerosingcholangitisaninvestigationusinganationwidedatabaseinjapan AT yusukeshimoyama impactofconcomitantulcerativecolitisontheclinicalcourseinpatientswithprimarysclerosingcholangitisaninvestigationusinganationwidedatabaseinjapan AT takeonaito impactofconcomitantulcerativecolitisontheclinicalcourseinpatientswithprimarysclerosingcholangitisaninvestigationusinganationwidedatabaseinjapan AT hisashishiga impactofconcomitantulcerativecolitisontheclinicalcourseinpatientswithprimarysclerosingcholangitisaninvestigationusinganationwidedatabaseinjapan AT shinhamada impactofconcomitantulcerativecolitisontheclinicalcourseinpatientswithprimarysclerosingcholangitisaninvestigationusinganationwidedatabaseinjapan AT yoichikakuta impactofconcomitantulcerativecolitisontheclinicalcourseinpatientswithprimarysclerosingcholangitisaninvestigationusinganationwidedatabaseinjapan AT kiyohidefushimi impactofconcomitantulcerativecolitisontheclinicalcourseinpatientswithprimarysclerosingcholangitisaninvestigationusinganationwidedatabaseinjapan AT kenjifujimori impactofconcomitantulcerativecolitisontheclinicalcourseinpatientswithprimarysclerosingcholangitisaninvestigationusinganationwidedatabaseinjapan AT yoshitakakinouchi impactofconcomitantulcerativecolitisontheclinicalcourseinpatientswithprimarysclerosingcholangitisaninvestigationusinganationwidedatabaseinjapan AT atsushimasamune impactofconcomitantulcerativecolitisontheclinicalcourseinpatientswithprimarysclerosingcholangitisaninvestigationusinganationwidedatabaseinjapan |