Analysis of the disease activity of ulcerative colitis with and without concomitant primary sclerosing cholangitis: An investigation using a nationwide database in Japan

Yano, Kota; Moroi, Rintaro; Shiga, Hisashi; Tarasawa, Kunio; Kuroha, Masatake; Hamada, Shin; Kakuta, Yoichi; Fushimi, Kiyohide; Fujimori, Kenji; Kinouchi, Yoshitaka; Masamune, Atsushi

doi:10.1002/jgh3.12693

Cited by 7 publications

(8 citation statements)

References 29 publications

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“…These results indicate that the disease activity of PSC is not different, regardless of concomitant UC. We previously reported a study regarding the impact of concomitant PSC in patients with UC [14], whose relationship was opposite to that of this study. Our previous study indicated that UC patients with PSC might have lower UC disease activity than patients with UC alone.…”

Section: Discussioncontrasting

confidence: 89%

“…These studies indicate that PSC and UC are expected to have a strong relationship and have the potential to affect each other's clinical course. Several studies have reported that the clinical course of UC associated with PSC is better than that of UC alone [ 9 , 10 , 11 , 12 , 13 , 14 ]. However, little is known about the impact of concomitant UC on the clinical course of PSC.…”

Section: Introductionmentioning

confidence: 99%

“…Therefore, the PSC-UC association may be better understood by performing an analysis of a large nationwide sample using DPC data. To date, clinical studies have been conducted using the DPC database [ 14 , 16 , 17 , 18 , 19 ]. This study aimed to investigate the impact of concomitant UC on the clinical course of patients with PSC, using a nationwide database in Japan.…”

Section: Introductionmentioning

confidence: 99%

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The Impact of Concomitant Ulcerative Colitis on the Clinical Course in Patients with Primary Sclerosing Cholangitis: An Investigation Using a Nationwide Database in Japan

et al. 2022

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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/Conclusion: 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.

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Section: Discussioncontrasting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The Impact of Concomitant Ulcerative Colitis on the Clinical Course in Patients with Primary Sclerosing Cholangitis: An Investigation Using a Nationwide Database in Japan

et al. 2022

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“…We have previously conducted clinical studies on IBD and other lower intestinal tract diseases using the Diagnostic Procedure Combination (DPC) nationwide database. 18 , 19 , 20 , 21 The DPC database contains a large number of admissions and enables analysis of IBD comorbidities, which makes it difficult to collect enough samples for a single‐center study.…”

Section: Introductionmentioning

confidence: 99%

Depression is associated with increased disease activity in patients with ulcerative colitis: A propensity score‐matched analysis using a nationwide database in Japan

et al. 2022

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Background and Aim The incidence and prevalence of psychiatric disorders are elevated in patients with inflammatory bowel disease (IBD). Whether psychiatric disorders could affect the clinical course of IBD is uncertain and controversial. We aimed to evaluate the impact of psychiatric disorders, particularly depression, on the clinical course of IBD using a nationwide database in Japan. Methods We collected data on admissions with IBD using the Diagnosis Procedure Combination database system introduced in Japan. We divided eligible admissions into IBD with and without depression groups using propensity score matching and compared the rates of surgery, use of molecular targeted drugs and biologics, systemic steroid administrations, and in‐hospital death. We also conducted a logistic regression analysis to identify clinical factors affecting surgery, the use of molecular targeted drugs and biologics, and systemic steroid administrations. Results The rates of surgery, use of two or more molecular targeted drugs, systemic steroid administrations, and in‐hospital deaths in the ulcerative colitis (UC) with depression group were higher than in the UC without depression group. Multivariate analysis of UC showed that depression increased the odds of systemic steroid administrations, use of two or more molecular targeted drugs, and surgery. However, analysis of Crohn's disease showed that only steroid administrations were associated with depression. Conclusion Our study demonstrated an association between a worse clinical course of UC and depression. Although this result indicates that depression might be associated with increased disease activity in patients with UC, the causal relationship is still unclear. Further prospective studies are warranted.

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“…The DPC database contains data for a large number of admissions 11 . This database has been used to conduct investigations targeting primary sclerosing cholangitis as a rare EIM of UC 12 in elderly patients with UC 13 and to evaluate a clinical guideline for AP 14 with sufficient data. Moreover, propensity (PS)‐score‐matched analyses have been performed to evaluate the efficacy of metallic stents for obstructive colorectal cancers and urgent colonoscopy for colonic diverticular bleeding using the same database 15,16 .…”

Section: Introductionmentioning

confidence: 99%

Severity of acute pancreatitis in patients with inflammatory bowel disease in the era of biologics: A propensity‐score‐matched analysis using a nationwide database in Japan

et al. 2022

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Background and Aim Acute pancreatitis (AP) is a rare extraintestinal manifestation of inflammatory bowel disease (IBD). Several studies from Western countries have reported that the severity of AP in patients with IBD is similar to that in the general population; however, its severity in patients from Eastern countries in the era of biologics remains unclear. This study aimed to investigate the severity of AP in patients with IBD and the effect of biologics on the severity of AP using a nationwide database. Methods We divided 1138 eligible AP admissions from the Diagnosis Procedure Combination database system into IBD and non‐IBD groups after propensity score matching, and compared the severity of AP. We divided the IBD group into ulcerative colitis (UC) and Crohn's disease (CD) subgroups and compared each with the non‐IBD group. Logistic regression analysis was conducted to identify the clinical factors affecting acute pancreatitis. Results IBD and UC groups had lower rate of severe AP compared to the non‐IBD group (13.7% vs 28.3%, P < 0.0001 and 11.0% vs 28.3%, P < 0.0001, respectively). There were no differences in the rates of severe AP between the CD and non‐IBD groups. Multivariate analysis showed that biologics did not affect the severity of AP. Conclusion The severity of AP in patients with IBD may be lower than that in the general population; biologics for IBD may not worsen its severity. Further prospective studies are required to clarify the severity of AP in patients with IBD.

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Analysis of the disease activity of ulcerative colitis with and without concomitant primary sclerosing cholangitis: An investigation using a nationwide database in Japan

Cited by 7 publications

References 29 publications

The Impact of Concomitant Ulcerative Colitis on the Clinical Course in Patients with Primary Sclerosing Cholangitis: An Investigation Using a Nationwide Database in Japan

The Impact of Concomitant Ulcerative Colitis on the Clinical Course in Patients with Primary Sclerosing Cholangitis: An Investigation Using a Nationwide Database in Japan

Depression is associated with increased disease activity in patients with ulcerative colitis: A propensity score‐matched analysis using a nationwide database in Japan

Severity of acute pancreatitis in patients with inflammatory bowel disease in the era of biologics: A propensity‐score‐matched analysis using a nationwide database in Japan

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