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High dose ursodeoxycholic acid in primary sclerosing cholangitis does not prevent colorectal neoplasia

Lindstrom, L. ; Boberg, K. M. ; Wikman, O. ; Friis-Liby, I. ; Hultcrantz, R. ; Prytz, Hanne LU ; Sandberg-Gertzen, H. ; Sangfelt, P. ; Rydning, A. and Folvik, G. , et al. (2012) In Alimentary pharmacology & therapeutics 35(4). p.451-457
Abstract
Background Patients with primary sclerosing cholangitis (PSC) and inflammatory bowel disease (IBD) have a high risk of developing colorectal cancer and dysplasia. Ursodeoxycholic acid (UDCA) has been suggested to have chemopreventive effects on the development of colorectal cancer and dysplasia but long-term data and larger trials are lacking. Aim To evaluate the effect of high dose (17-23 mg/kg/day) UDCA on colorectal neoplasia in a cohort of patients with PSC and IBD. Methods From our previous 5-year randomised controlled trial of UDCA vs. placebo in PSC, we performed a follow-up of 98 patients with concomitant IBD from entry of the trial 1996-1997 until 2009 for development of colorectal cancer or dysplasia. Results The total follow-up... (More)
Background Patients with primary sclerosing cholangitis (PSC) and inflammatory bowel disease (IBD) have a high risk of developing colorectal cancer and dysplasia. Ursodeoxycholic acid (UDCA) has been suggested to have chemopreventive effects on the development of colorectal cancer and dysplasia but long-term data and larger trials are lacking. Aim To evaluate the effect of high dose (17-23 mg/kg/day) UDCA on colorectal neoplasia in a cohort of patients with PSC and IBD. Methods From our previous 5-year randomised controlled trial of UDCA vs. placebo in PSC, we performed a follow-up of 98 patients with concomitant IBD from entry of the trial 1996-1997 until 2009 for development of colorectal cancer or dysplasia. Results The total follow-up time was 760 person-years. Dysplasia/cancer-free survival was compared between placebo-(n = 50) and UDCA-treated (n = 48) patients. There was a similar frequency of dysplasia or cancer after 5 years between patients originally assigned to UDCA or placebo (13% vs. 16%) and no difference in dysplasia/cancer-free survival (P = 0.46, log rank test). At the end of 2009 no difference in cancer-free survival was detected, 30% of the placebo patients compared with 27% of UDCA patients had developed colorectal cancer or dysplasia. Conclusions Long-term high dose ursodeoxycholic acid does not prevent colorectal cancer or dysplasia in patients with primary sclerosing cholangitis-associated inflammatory bowel disease. (Less)
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organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Alimentary pharmacology & therapeutics
volume
35
issue
4
pages
451 - 457
publisher
Wiley-Blackwell
external identifiers
  • wos:000299154900005
  • scopus:84856029918
  • pmid:22221173
ISSN
0269-2813
DOI
10.1111/j.1365-2036.2011.04966.x
language
English
LU publication?
yes
id
0f29839c-e4ad-4ace-83ff-1422806d66a0 (old id 2416250)
date added to LUP
2016-04-01 14:10:03
date last changed
2022-04-14 08:20:19
@article{0f29839c-e4ad-4ace-83ff-1422806d66a0,
  abstract     = {{Background Patients with primary sclerosing cholangitis (PSC) and inflammatory bowel disease (IBD) have a high risk of developing colorectal cancer and dysplasia. Ursodeoxycholic acid (UDCA) has been suggested to have chemopreventive effects on the development of colorectal cancer and dysplasia but long-term data and larger trials are lacking. Aim To evaluate the effect of high dose (17-23 mg/kg/day) UDCA on colorectal neoplasia in a cohort of patients with PSC and IBD. Methods From our previous 5-year randomised controlled trial of UDCA vs. placebo in PSC, we performed a follow-up of 98 patients with concomitant IBD from entry of the trial 1996-1997 until 2009 for development of colorectal cancer or dysplasia. Results The total follow-up time was 760 person-years. Dysplasia/cancer-free survival was compared between placebo-(n = 50) and UDCA-treated (n = 48) patients. There was a similar frequency of dysplasia or cancer after 5 years between patients originally assigned to UDCA or placebo (13% vs. 16%) and no difference in dysplasia/cancer-free survival (P = 0.46, log rank test). At the end of 2009 no difference in cancer-free survival was detected, 30% of the placebo patients compared with 27% of UDCA patients had developed colorectal cancer or dysplasia. Conclusions Long-term high dose ursodeoxycholic acid does not prevent colorectal cancer or dysplasia in patients with primary sclerosing cholangitis-associated inflammatory bowel disease.}},
  author       = {{Lindstrom, L. and Boberg, K. M. and Wikman, O. and Friis-Liby, I. and Hultcrantz, R. and Prytz, Hanne and Sandberg-Gertzen, H. and Sangfelt, P. and Rydning, A. and Folvik, G. and Gangsoy-Kristiansen, M. and Danielsson, A. and Bergquist, Annika}},
  issn         = {{0269-2813}},
  language     = {{eng}},
  number       = {{4}},
  pages        = {{451--457}},
  publisher    = {{Wiley-Blackwell}},
  series       = {{Alimentary pharmacology & therapeutics}},
  title        = {{High dose ursodeoxycholic acid in primary sclerosing cholangitis does not prevent colorectal neoplasia}},
  url          = {{http://dx.doi.org/10.1111/j.1365-2036.2011.04966.x}},
  doi          = {{10.1111/j.1365-2036.2011.04966.x}},
  volume       = {{35}},
  year         = {{2012}},
}