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Predictors of Outcome in Ulcerative Colitis.

Publication ,  Journal Article
Waterman, M; Knight, J; Dinani, A; Xu, W; Stempak, JM; Croitoru, K; Nguyen, GC; Cohen, Z; McLeod, RS; Greenberg, GR; Steinhart, AH; Silverberg, MS
Published in: Inflamm Bowel Dis
September 2015

BACKGROUND: Approximately 80% of patients with ulcerative colitis (UC) have intermittently active disease and up to 20% will require a colectomy, but little data available on predictors of poor disease course. The aim of this study was to identify clinical and genetic markers that can predict prognosis. METHODS: Medical records of patients with UC with ≥5 years of follow-up and available DNA and serum were retrospectively assessed. Immunochip was used to genotype loci associated with immune mediated inflammatory disorders (IMIDs), inflammatory bowel diseases, and other single nucleotide polypmorphisms previously associated with disease severity. Serum levels of pANCA, ASCA, CBir1, and OmpC were also evaluated. Requirement for colectomy, medication, and hospitalization were used to group patients into 3 prognostic groups. RESULTS: Six hundred one patients with UC were classified as mild (n = 78), moderate (n = 273), or severe disease (n = 250). Proximal disease location frequencies at diagnosis were 13%, 21%, and 30% for mild, moderate, and severe UC, respectively (P = 0.001). Disease severity was associated with greater proximal extension rates on follow-up (P < 0.0001) and with shorter time to extension (P = 0.03) and to prednisone initiation (P = 0.0004). When comparing severe UC with mild and moderate UC together, diagnosis age >40 and proximal disease location were associated with severe UC (odds ratios = 1.94 and 2.12, respectively). None of the single nucleotide polypmorphisms or serum markers tested was associated with severe UC, proximal disease extension or colectomy. CONCLUSIONS: Older age and proximal disease location at diagnosis, but not genetic and serum markers, were associated with a more severe course. Further work is required to identify biomarkers that will predict outcomes in UC.

Duke Scholars

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Published In

Inflamm Bowel Dis

DOI

EISSN

1536-4844

Publication Date

September 2015

Volume

21

Issue

9

Start / End Page

2097 / 2105

Location

England

Related Subject Headings

  • Young Adult
  • Saccharomyces cerevisiae
  • Retrospective Studies
  • Prognosis
  • Prednisone
  • Predictive Value of Tests
  • Porins
  • Polymorphism, Single Nucleotide
  • Odds Ratio
  • Middle Aged
 

Citation

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Waterman, M., Knight, J., Dinani, A., Xu, W., Stempak, J. M., Croitoru, K., … Silverberg, M. S. (2015). Predictors of Outcome in Ulcerative Colitis. Inflamm Bowel Dis, 21(9), 2097–2105. https://doi.org/10.1097/MIB.0000000000000466
Waterman, Matti, Jo Knight, Amreen Dinani, Wei Xu, Joanne M. Stempak, Kenneth Croitoru, Geoffrey C. Nguyen, et al. “Predictors of Outcome in Ulcerative Colitis.Inflamm Bowel Dis 21, no. 9 (September 2015): 2097–2105. https://doi.org/10.1097/MIB.0000000000000466.
Waterman M, Knight J, Dinani A, Xu W, Stempak JM, Croitoru K, et al. Predictors of Outcome in Ulcerative Colitis. Inflamm Bowel Dis. 2015 Sep;21(9):2097–105.
Waterman, Matti, et al. “Predictors of Outcome in Ulcerative Colitis.Inflamm Bowel Dis, vol. 21, no. 9, Sept. 2015, pp. 2097–105. Pubmed, doi:10.1097/MIB.0000000000000466.
Waterman M, Knight J, Dinani A, Xu W, Stempak JM, Croitoru K, Nguyen GC, Cohen Z, McLeod RS, Greenberg GR, Steinhart AH, Silverberg MS. Predictors of Outcome in Ulcerative Colitis. Inflamm Bowel Dis. 2015 Sep;21(9):2097–2105.
Journal cover image

Published In

Inflamm Bowel Dis

DOI

EISSN

1536-4844

Publication Date

September 2015

Volume

21

Issue

9

Start / End Page

2097 / 2105

Location

England

Related Subject Headings

  • Young Adult
  • Saccharomyces cerevisiae
  • Retrospective Studies
  • Prognosis
  • Prednisone
  • Predictive Value of Tests
  • Porins
  • Polymorphism, Single Nucleotide
  • Odds Ratio
  • Middle Aged