P373 Primary sclerosing cholangitis associated with inflammatory bowel disease: clinical characteristics of patients from reference centers in Brazil
Notice bibliographique
Résumé
Abstract Background Inflammatory bowel disease (IBD) and primary sclerosing cholangitis (PSC) are closely associated pathological entities that, when present in combination, create a phenotypically different disease, referred to as PSC-IBD. The occurrence of PSC complicating IBD seems to vary depending on the studied population. The aim of this study was to describe the clinical profile of patients with PSC-IBD in reference centers in Brazil. Methods Descriptive cross-sectional study in 7 tertiary centers. Patients with PSC and IBD were identified. Data were collected from patients' charts. The following variables were studied: age, age at diagnosis of IBD and PSC, type of IBD, Montreal classification, medications used, occurrence of colorectal cancer and dysplasia, colectomy and liver complications. The study was approved by the ethics and research committee. Results Ninety-three patients were included. The mean age of the patients was 43,8 years (range 17 to 73). 63 patients were male (67.7%). UC was more frequent 74.2% (N=69). The mean age at diagnosis of IBD and PSC was 31.4 years (range 6 to 67) and 35.6 years (range 8 to 72), respectively. The diagnosis of PSC preceded that of IBD in only 15 (16.1%) cases. Among patients with UC, the majority (61/69) had extensive colitis (88.4%), and 47.8% (33/69) had already used at least one biological therapy. Only 9 (13%) patients with UC required colectomy. Regarding CD, colon involvement occurred in 21 (87.5%) patients and 20 (83.3%) needed to use at least one biologic. Just 3 CD patients (12.5%) had isolated disease in the small intestine. In our study, liver cirrhosis occurred in 20 (21,5%) cases of the studied population, and 13 (14%) patients required liver transplantation. Fourteen (15,1%) IBD patients had dysplasia or colorectal cancer (CRC). Use of biological therapy was more frequent in patients with CD than in those with UC (83.3% vs 47.8%; p=0.002). There was a trend towards a higher occurrence of CRC in the UC population (p=0.08). Conclusion In our studied PSC-IBD population, UC was more common than CD. Furthermore, we observed that in this subgroup of IBD with PSC, UC presented a more severe phenotype, with a superior occurrence of extensive colitis and need for biological therapy. In CD, most patients have colonic involvement. Interestingly, we observed a greater need to use at least one biologic in CD patients (p=0.002), as well as the need to use multiple biologics compared to UC patients (p=0.009). Additionally, there was a trend towards greater occurrence of CRC in UC patients. The rates of occurrence of dysplasia and liver cirrhosis in our casuistic emphasize the demand for more intensive follow-up in patients with IBD and PSC.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».