656 High Prevalence of Fatigue in Patients With Sclerosing Cholangitis

Al-Harthy, Nadya; Kumagi, Teru; Parasar, S.; Coltescu, Catalina; Heathcote, E.J.; Hirschfield, Gideon

doi:10.1016/s0168-8278(09)60658-9

Cited by 5 publications

(9 citation statements)

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“…Provisional justification for our decision has been obtained from two sources. First, Al-Hardy et al have reported as early as in 2009, in a form of an abstract that PBC-40 can be used for PSC [2]. We ourselves applied nowadays PBC-40 and PBC-27 in the studies that we undertook in our patients with PSC [29].…”

Section: Discussionmentioning

confidence: 99%

Prospective evaluation of PBC‐specific health‐related quality of life questionnaires in patients with primary sclerosing cholangitis

Raszeja‐Wyszomirska

Krawczyk

Rigopoulou

et al. 2014

Liver International

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Section: Discussionmentioning

confidence: 99%

Prospective evaluation of PBC‐specific health‐related quality of life questionnaires in patients with primary sclerosing cholangitis

Raszeja‐Wyszomirska

Krawczyk

Rigopoulou

et al. 2014

Liver International

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“…HRQoL was assessed with both generic (the Medical Outcomes Study Short Form‐36; SF‐36) and disease‐specific questionnaires (PBC‐40). The PBC‐40 was constructed for evaluation of HRQoL in patients with PBC and, more recently, has been used in patients with PSC . The PBC‐40 contains 40 questions in the following domains: fatigue, cognitive, social‐emotional, itch, and other symptoms, with higher scores indicating poorer HRQoL.…”

Section: Methodsmentioning

confidence: 99%

Prospective evaluation of ursodeoxycholic acid withdrawal in patients with primary sclerosing cholangitis

et al. 2014

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Ursodeoxycholic acid (UDCA) is no longer recommended for management of adult patients with primary sclerosing cholangitis (PSC). We undertook a prospective evaluation of UDCA withdrawal in a group of consecutive patients with PSC. Twenty six patients, all treated with UDCA (dose range: 10-15 mg/kg/day) were included. Paired blood samples for liver biochemistry, bile acids, and fibroblast growth factor 19 (FGF19) were collected before UDCA withdrawal and 3 months later. Liquid chromatography/tandem mass spectrometry was used for quantification of 29 plasma bile acid metabolites. Pruritus and health-related quality of life (HRQoL) were assessed with a 10-point numeric rating scale, the Medical Outcomes Study Short Form-36 (SF-36), and PBC-40 questionnaires. UDCA withdrawal resulted in a significant deterioration in liver biochemistry (increase of alkaline phosphatase of 75.6%; P < 0.0001; gamma-glutamyl transpeptidase of 117.9%, P < 0.0001; bilirubin of 50.0%, P < 0.001; alanine aminotransferase of 63.9%, P < 0.005; and aspartate aminotransferase of 45.0%, P < 0.005) and increase of Mayo Risk Score for PSC (change from baseline of 10.5 point; P < 0.003). Bile acid analysis revealed a significant decrease in lithocholic acid and its derivatives after UDCA withdrawal, but no effect on concentrations of primary bile acids aside from an increased accumulation of their taurine conjugates. After UDCA removal cholestatic parameters, taurine species of cholic acid and chenodeoxycholic acid correlated with serum FGF19 levels. No significant effect on HRQoL after UDCA withdrawal was observed; however, 42% of patients reported a deterioration in their pruritus. Conclusion: At 3 months, discontinuation of UDCA in patients with PSC causes significant deterioration in liver biochemistry and influences concentrations of bile acid metabolites. A proportion of patients report increased pruritus, but other short-term markers of quality of life are unaffected. (HEPATOLOGY 2014;60:931-940)

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“…However, there is still a controversy about specificity of fatigue in PSC. It did not seem to be a specific complaint of PSC in Benito de Vale et al study ( 26 ), but Al-Harthy et al found that fatigue was an important, but under reported symptom for patients with PSC, particularly in female patients ( 11 ). IBD presence was also associated with more severe fatigue in PSC patients in Al-Rifai et al study on 138 participants ( 29 ).…”

Section: Discussionmentioning

confidence: 87%

“…Possible range of each domain was symptom domain 7 - 35, itching 3 - 15, fatigue 11 - 55, cognitive 6-30 and social and emotional functions 13 - 65 points ( 10 ). PBC-40 was also used in HRQoL evaluation in patients with PSC ( 11 ).…”

Section: Methodsmentioning

confidence: 99%

The Impact of Fragility Fractures on Health-Related Quality of Life in Patients With Primary Sclerosing Cholangitis

et al. 2015

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Background:Osteoporosis occurs frequently in patients with chronic cholestatic liver diseases, yet data are scarce regarding the prevalence of osteoporosis and fragility fractures and their impact on Health-Related Quality of Life (HRQoL) in Primary Sclerosing Cholangitis (PSC).Objectives:We aimed to assess Bone Mineral Density (BMD), physical activity and incidence of fragility fractures in patients with PSC. We also sought associations between prior fractures and HRQoL.Patients and Methods:The study was performed on 33 patients (11 females, 22 males) aged 35.3 ± 13 years. HRQoL was assessed by Short Form (SF)-36, Primary Biliary Cirrhosis (PBC)-40 and PBC-27 questionnaires. BMD was measured by densitometry in the lumbar spine and hip. Physical activity was assessed by questionnaire.Results:In 32% of patients, BMD measured in the hip or spine was below 1.0 Standard Deviation. A history of fragility fractures (distal forearm and ribs) was reported in six patients (18%). In SF-36 assessment, patients with fractures had lower scores in the role functioning, general health and vitality domains and Physical Component Summary (PCS) than those without fractures. Prior fractures adjusted for gender and PSC duration were associated with lower PCS and Mental Component Summary (MCS) scores. Symptoms and fatigue (assessed by PBC) and prior fractures were inversely associated with MCS (P = 0.007).Conclusions:In middle-aged subjects with PSC, we found a high rate of non-vertebral fractures and a moderately decreased BMD in lumbar spine and hip. Fragility fractures had an impact on physical and mental aspects of HRQoL.

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656 High Prevalence of Fatigue in Patients With Sclerosing Cholangitis

Cited by 5 publications

References 0 publications

Prospective evaluation of PBC‐specific health‐related quality of life questionnaires in patients with primary sclerosing cholangitis

Prospective evaluation of PBC‐specific health‐related quality of life questionnaires in patients with primary sclerosing cholangitis

Prospective evaluation of ursodeoxycholic acid withdrawal in patients with primary sclerosing cholangitis

The Impact of Fragility Fractures on Health-Related Quality of Life in Patients With Primary Sclerosing Cholangitis

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