Risk for Colorectal Neoplasia in Patients With Colonic Crohn's Disease and Concomitant Primary Sclerosing Cholangitis

Braden, Barbara; Halliday, John; Aryasingha, Sanjeewa; Sharifi, Yalda; Checchin, D.; Warren, Bryan F.; Kitiyakara, Taya; Travis, Simon; Chapman, Roger W.

doi:10.1016/j.cgh.2011.10.020

Cited by 44 publications

(24 citation statements)

References 34 publications

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“…In terms of additional risk for developing CRC in patients with Crohn's colitis and PSC, there are only two other studies specifically addressing this issue, and both are small, with conflicting results (one showed an increased risk and one did not), and hence it is not clear whether PSC increases the risk of colonoscopic dysplasia/malignancy in Crohn's disease [40,41]. …”

Section: Malignancymentioning

confidence: 99%

Primary Sclerosing Cholangitis

Williamson

Chapman

2014

Dig Dis

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Primary sclerosing cholangitis (PSC) is a chronic, cholestatic liver disease caused by diffuse inflammation and fibrosis that can involve the entire biliary tree. It is a progressive disorder which can ultimately lead to biliary cirrhosis, portal hypertension and hepatic failure. PSC is a complex genetic disorder with male predominance. Environmental predisposing factors include non-smoking. It is closely associated with inflammatory bowel disease (IBD), particularly ulcerative colitis, which occurs in about two thirds of PSC cases. Recent studies have suggested that PSC-IBD is a separate disease entity from IBD alone with distinctive genetic and phenotypic characteristics. Most PSC patients are asymptomatic at presentation; clinical symptoms include fatigue, jaundice, weight loss, right upper quadrant pain and pruritis. Serum biochemical tests indicate cholestasis, and diagnosis is usually established by cholangiography. In symptomatic patients, median survival from presentation to death or liver transplantation is about 12 years. It is a premalignant condition, and the majority of deaths are from malignancy, particularly cholangiocarcinoma or colonic cancer. PSC has no curative treatment. Medical treatment with ursodeoxycholic acid may slow progression of the disease and reduce colonic dysplasia, though trials lack statistical significance. Liver transplantation is the only option in young patients with PSC and advanced liver disease.

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Section: Malignancymentioning

confidence: 99%

Primary Sclerosing Cholangitis

Williamson

Chapman

2014

Dig Dis

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“…[19][20][21][22][31][32][33][34] One study was published only in the abstract form. 34 Four studies were excluded since relative risk or OR could not be calculated.…”

Section: Search Resultsmentioning

confidence: 99%

“…Specifically, doses between 8 and 15 mg/kg/d were associated with a significant reduction in the risk of CRN in 2 studies, 19,20 whereas doses between 15 and 30 mg/kg/d did not modify the risk of CRN in 3 studies. 22,31,33 For 2 of the other studies, only the median dose of UDCA was reported, and thus, a formal subgroup analysis by dose range of UDCA could not be conducted. 21,32 These differences in UDCA dose and the observed dose-dependent effect of UDCA may account for the lack of significant effect on overall CRN risk observed in our study.…”

Section: Discussionmentioning

confidence: 96%

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Effect of Ursodeoxycholic Acid Use on the Risk of Colorectal Neoplasia in Patients with Primary Sclerosing Cholangitis and Inflammatory Bowel Disease

Singh

Khanna

Pardi

et al. 2013

Inflammatory Bowel Diseases

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“…There is no evidence that the use of UDCA reduces the risk of development of gallbladder cancer in patients with PSC. As for colorectal cancer (CRC), the real impact of the use of UDCA remains unclear, with two studies suggesting a protective effect (92,93) , four studies noting no impact (94)(95)(96)(97) and one study indicating increased risk of CRC in UDCA users (98) . Recent meta-analysis found no association between the use of UDCA and the risk of CRC or dysplasia in adults with PSC and IBD (99) .…”

Section: Pharmacological Treatment Of Pscmentioning

confidence: 99%

Brazilian society of hepatology recommendations for the diagnosis and management of autoimmune diseases of the liver

Bittencourt

Cançado

Couto

et al. 2015

Arq. Gastroenterol.

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-In order to draw evidence-based recommendations concerning the management of autoimmune diseases of the liver, the Brazilian Society of Hepatology has sponsored a single-topic meeting in October 18th, 2014 at São Paulo. An organizing committee comprised of seven investigators was previously elected by the Governing Board to organize the scientific agenda as well as to select twenty panelists to make a systematic review of the literature and to present topics related to the diagnosis and treatment of autoimmune hepatitis, primary sclerosing cholangitis, primary biliary cirrhosis and their overlap syndromes. After the meeting, all panelists gathered together for the discussion of the topics and the elaboration of those recommendations. The text was subsequently submitted for suggestions and approval of all members of the Brazilian Society of Hepatology through its homepage. The present paper is the final version of the reviewed manuscript organized in topics, followed by the recommendations of the Brazilian Society of Hepatology.

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Risk for Colorectal Neoplasia in Patients With Colonic Crohn's Disease and Concomitant Primary Sclerosing Cholangitis

Cited by 44 publications

References 34 publications

Primary Sclerosing Cholangitis

Primary Sclerosing Cholangitis

Effect of Ursodeoxycholic Acid Use on the Risk of Colorectal Neoplasia in Patients with Primary Sclerosing Cholangitis and Inflammatory Bowel Disease

Brazilian society of hepatology recommendations for the diagnosis and management of autoimmune diseases of the liver

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