The Natural History of Ulcerative Proctitis: A Multicenter, Retrospective Study

Meucci, Gianmichele; Vecchi, Massimiliano De; Astegiano, Marco; Beretta, Luigi; Cesari, P.; Dizioli, Paolo; Ferraris, L.; Mr, Panelli; Prada, Alberto; Sostegni, R.; R, de Franchis

doi:10.1111/j.1572-0241.2000.t01-1-01770.x

Cited by 136 publications

(75 citation statements)

References 22 publications

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“…Since the disease extent in UC is dynamic, it is possible that a true difference does not exist as we may not have measured the maximal extent of disease in AA [19,20]. It is also possible that some differential bias exists in classifying extent of disease in AA.…”

Section: Discussionmentioning

confidence: 92%

Racial Differences in Disease Extent and Severity in Patients with Ulcerative Colitis: A Retrospective Cohort Study

et al. 2008

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Section: Discussionmentioning

confidence: 92%

Racial Differences in Disease Extent and Severity in Patients with Ulcerative Colitis: A Retrospective Cohort Study

et al. 2008

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“…Nevertheless, data on clinical predictors of disease extension in ulcerative proctitis are sparse. In addition, prior studies evaluating risk factors for disease extension in ulcerative proctitis were limited by small sample size, single center experience, limited follow up time, and lack of detailed information on lifestyle factors 4,6,8,10 . Finally, there is a paucity of data on differences in treatment course and disease complications between proctitis patients with disease extension to those without.…”

Section: Introductionmentioning

confidence: 99%

Clinical Predictors and Natural History of Disease Extension in Patients with Ulcerative Proctitis

Walsh

Chah

Chin

et al. 2017

Inflammatory Bowel Diseases

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Background A proportion of patients with initial presentation of ulcerative proctitis (UP) progress to more extensive colitis. We sought to characterize the natural history and identify clinical predictors of extension in UP. Methods We performed a retrospective cohort study of participants with a new diagnosis of UP from January 2000 to December 2015. We used cox proportional hazard modeling to identify predictors of disease extension. Results Through December of 2015, we identified 169 cases of UP with a median age of diagnosis of 40 years (range: 16–91 years) and a median follow up of 4.3 years (range: 3.3–15.1 years). 53 (31%) patients developed extension over the follow up time. Compared to non-extenders, the need for immunosuppressive or biologic therapy was significantly higher among extenders (34% vs. 2.6%, p < 0.001). In multivariable analyses, compared to UP cases with BMI < 25, the adjusted hazard ratios (aHRs) of extension were 1.75 (95% CI, 0.95 – 3.23) and 2.77 (95% CI, 1.07 – 7.14) among overweight and obese patients, respectively (Ptrend = 0.03). Similarly, patients with a history of appendectomy or endoscopic finding of moderate to severe disease had a higher risk of extension (aHR = 2.74, 95% CI 1.07 – 7.01 and 1.96, 95% CI 1.05–3.67, respectively). Conclusion In a retrospective cohort study, we show that appendectomy, BMI, and endoscopic activity at the time of diagnosis of proctitis are associated with increased risk of extension. In addition, our data suggest that extenders are more likely to require immunosuppressive or biologic therapy.

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“…[10][11][12][13][14][15] In our series, a striking result was that over 50% of patients with proctitis displayed a disease extension over time. This finding might have practical implication in medical management and follow-up.…”

Section: Discussionmentioning

confidence: 96%