Risk factors for complications in patients with ulcerative colitis

Swiss Inflammatory Bowel Disease Cohort Study

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background: Patients with ulcerative colitis may develop extraintestinal manifestations like erythema nodosum or primary sclerosing cholangitis or extraintestinal complications like anaemia, malabsorption or they may have to undergo surgery. Objective: The aim of this study was to investigate potential risk factors for complications like anaemia, malabsorption or surgery in ulcerative colitis. Methods: Data on 179 patients with ulcerative colitis were retrieved from our cross-sectional and prospective Swiss Inflammatory Bowel Disease Cohort Study data base for a median observational time of 4.2 years. Data were compared between patients with (n = 140) or without (n = 39) complications. Gender, age at diagnosis, smoking status, disease extent, delay of diagnosis or therapy, mesalamine (5-ASA) systemic and topical therapy, as well as other medication were analysed as potential impact factors. Results: In the multivariate regression analysis a delay of 5-ASA treatment by at least two months (odds ratio (OR) 6.21 (95% confidence interval (CI) 2.13-18.14), p = 0.001) as well as a delay with other medication with thiopurines (OR 6.48 (95% CI 2.01-20.91), p = 0.002) were associated with a higher risk for complications. This significant impact of a delay of 5-ASA therapy was demonstrated for extraintestinal manifestations (EIMs) as well as extraintestinal complications (EICs). Extensive disease as well as therapy with methotrexate showed a significantly increased risk for surgery (extensive disease: OR 2.62 (1.02-6.73), p = 0.05, methotrexate: OR 5.36 (1.64-17.58), p = 0.006). Conclusions: A delay of 5-ASA therapy of more than two months in the early stage of ulcerative colitis (UC) constitutes a risk for complications during disease course. Extensive disease is associated with a higher risk for surgery.

Original languageEnglish
Pages (from-to)281-287
Number of pages7
JournalUnited European Gastroenterology Journal
Volume4
Issue number2
DOIs
Publication statusPublished - Jan 1 2016

Fingerprint

Ulcerative Colitis
Odds Ratio
Methotrexate
Anemia
Therapeutics
Confidence Intervals
Erythema Nodosum
Mesalamine
Sclerosing Cholangitis
Inflammatory Bowel Diseases
Cohort Studies
Multivariate Analysis
Smoking
Regression Analysis
Databases

Keywords

  • Complication
  • Extraintestinal manifestation
  • Mesalamine
  • Risk factor
  • Ulcerative colitis

ASJC Scopus subject areas

  • Oncology
  • Gastroenterology

Cite this

Risk factors for complications in patients with ulcerative colitis. / Swiss Inflammatory Bowel Disease Cohort Study.

In: United European Gastroenterology Journal, Vol. 4, No. 2, 01.01.2016, p. 281-287.

Research output: Contribution to journalArticle

Swiss Inflammatory Bowel Disease Cohort Study. / Risk factors for complications in patients with ulcerative colitis. In: United European Gastroenterology Journal. 2016 ; Vol. 4, No. 2. pp. 281-287.
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abstract = "Background: Patients with ulcerative colitis may develop extraintestinal manifestations like erythema nodosum or primary sclerosing cholangitis or extraintestinal complications like anaemia, malabsorption or they may have to undergo surgery. Objective: The aim of this study was to investigate potential risk factors for complications like anaemia, malabsorption or surgery in ulcerative colitis. Methods: Data on 179 patients with ulcerative colitis were retrieved from our cross-sectional and prospective Swiss Inflammatory Bowel Disease Cohort Study data base for a median observational time of 4.2 years. Data were compared between patients with (n = 140) or without (n = 39) complications. Gender, age at diagnosis, smoking status, disease extent, delay of diagnosis or therapy, mesalamine (5-ASA) systemic and topical therapy, as well as other medication were analysed as potential impact factors. Results: In the multivariate regression analysis a delay of 5-ASA treatment by at least two months (odds ratio (OR) 6.21 (95{\%} confidence interval (CI) 2.13-18.14), p = 0.001) as well as a delay with other medication with thiopurines (OR 6.48 (95{\%} CI 2.01-20.91), p = 0.002) were associated with a higher risk for complications. This significant impact of a delay of 5-ASA therapy was demonstrated for extraintestinal manifestations (EIMs) as well as extraintestinal complications (EICs). Extensive disease as well as therapy with methotrexate showed a significantly increased risk for surgery (extensive disease: OR 2.62 (1.02-6.73), p = 0.05, methotrexate: OR 5.36 (1.64-17.58), p = 0.006). Conclusions: A delay of 5-ASA therapy of more than two months in the early stage of ulcerative colitis (UC) constitutes a risk for complications during disease course. Extensive disease is associated with a higher risk for surgery.",
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AU - Manser, Christine N.

AU - Borovicka, Jan

AU - Seibold, Frank

AU - Vavricka, Stephan R.

AU - Lakatos, P.

AU - Fried, Michael

AU - Rogler, Gerhard

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