P224 Primary sclerosing cholangitis in the Swiss Inflammatory Bowel Disease Cohort: prevalence, risk factors, and long-term follow-up
M. Fraga*1, N. Fournier2, E. Safroneeva3, V. Pittet4, A. Nydegger5, S. Vavricka6, D. Moradpour1, A. Schoepfer1
1CHUV - Centre Hospitalier Universitaire Vaudois, Department of Gastroenterology and Hepatology, Lausanne, Switzerland, 2Institute for Social and Preventive Medicine, Healthcare Evaluation Unit, Lausanne, Switzerland, 3Institute of Social and Preventive Medicine, Division of Clinical Epidemiology and Biostatics, University of Bern, Bern, Switzerland, 4Institute For Social And Preventive Medicine, Health Care Evaluation Unit, Lausanne, Switzerland, 5Centre Hospitalier Universitaire Vaudois CHUV, Unité de Gastroentérologie / Nutrition pédiatrique, Lausanne, Switzerland, 6Stadtspital Triemli, Department of Gastroenterology and Hepatology, Zurich, Switzerland
Primary sclerosing cholangitis (PSC) represents the most common hepatobiliary extraintestinal manifestation (EIM) in inflammatory bowel disease (IBD). We aimed to assess the prevalence of PSC in the Swiss IBD Cohort Study (SIBDCS), to identify associated risk factors, and to describe the long-term evolution.
Patients were enrolled retrospectively (diagnosis before 2006) and prospectively (diagnosis in 2006 and later) into the SIBDCS; 80% of patients were recruited in hospitals and 20% in private practice.
Amongst 2 744 patients with IBD (1 188 Crohn’s disease [CD]; 1 556 ulcerative colitis [UC]), 57 suffered from concomitant PSC (48 PSC-UC, 9 PSC-CD). PSC prevalence was higher in UC when compared with CD patients (3.1% vs 0.75%, p < 0.001). UC-PSC patients (n = 48) were characterised by the following criteria when compared with UC patients without PSC (n = 1,140): they were more frequently male (77.1% vs 53%, p = 0.007), they were younger at UC diagnosis (median 24 [IQR 18–35] vs 31 [IQR 23–40] years, p = 0.001) and suffered more frequently from pancolitis (55.3% vs 37.8%, p = 0.117). 4/57 (7%) of PSC patients developed cholangiocarcinoma, 6/57 (12.5%) underwent liver transplantation and 5/57 died (10.4%).
Approximately 3% of UC patients and 0.6% of CD patients suffered from PSC. Male gender, young age at IBD diagnosis, and pancolitis were risk factors for developing PSC in UC patients. PSC is associated with considerable morbidity and mortality in the long-term run.