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The impact of ursodeoxycholic acid on cancer, dysplasia and mortality in ulcerative colitis patients with primary sclerosing cholangitis
Author(s) -
WOLF J. M.,
RYBICKI L. A.,
LASHNER B. A.
Publication year - 2005
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/j.1365-2036.2005.02650.x
Subject(s) - medicine , primary sclerosing cholangitis , ursodeoxycholic acid , ulcerative colitis , gastroenterology , dysplasia , cancer , colorectal cancer , disease
Summary Background : Colorectal cancer in primary sclerosing cholangitis patients with ulcerative colitis is mostly right‐sided where concentrations of carcinogenic secondary bile acids are highest. Aim : To investigate whether ursodeoxycholic acid could be chemopreventive for colorectal cancer. Methods : A historical cohort study was performed on primary sclerosing cholangitis patients with ulcerative colitis where the 28 patients (cases) who were treated with ursodeoxycholic acid for at least 6 months (mean 3.4 ± 2.7 years) were compared with the 92 patients (controls) who were not treated with ursodeoxycholic acid. The primary outcomes were colorectal cancer and dysplasia. The secondary outcome was overall mortality. Results : The cumulative incidence of dysplasia or cancer was not significantly different between cases and controls ( P = 0.17 by log‐rank test). The adjusted relative risk for cases of developing dysplasia or cancer was 0.59 (95% CI 0.26–1.36). The cumulative mortality was significantly different between groups ( P = 0.02 by log‐rank test). The adjusted relative risk for cases of death was 0.44 (95% CI 0.22–0.90). Conclusion : In ulcerative colitis patients with primary sclerosing cholangitis, ursodeoxycholic acid did not reduce the risk of developing cancer or dysplasia. However, ursodeoxycholic acid may reduce mortality.