Post-inflammatory polyps burden as a prognostic marker of disease-outcome in patients with inflammatory bowel disease

Ellul, P; Schembri, J; Baldacchino, Vella A; Molnar, T; Resal, T; Allocca, M A; Furfaro, F; Buono, Dal; Theodoropoulou, A; Fragaki, M; Tsoukali, E; Mantzaris, G J; Phillips, F; Radford, S; Moran, G; Gonzalez, H A; Sebastian, S; Fousekis, F; Christodoulou, D; Snir, Y; Lerner, Z; Yanai, H; Michalopoulos, G; Tua, J; Camilleri, L; Papamichael, K; Karmiris, K; Katsanos, K

doi:10.1093/ecco-jcc/jjac169

Post-inflammatory polyps burden as a prognostic marker of disease-outcome in patients with inflammatory bowel disease

Ellul, P; Schembri, J; Baldacchino, Vella A; Molnar, T; Resal, T; Allocca, M A; Furfaro, F; Buono, Dal; Theodoropoulou, A; Fragaki, M; Tsoukali, E; Mantzaris, G J; Phillips, F; Radford, S; Moran, G; Gonzalez, H A; Sebastian, S; Fousekis, F; Christodoulou, D; Snir, Y; Lerner, Z; Yanai, H; Michalopoulos, G; Tua, J; Camilleri, L; Papamichael, K; Karmiris, K; Katsanos, K

Authors

P Ellul

J Schembri

Vella A Baldacchino

T Molnar

T Resal

M A Allocca

F Furfaro

Dal Buono

A Theodoropoulou

M Fragaki

E Tsoukali

G J Mantzaris

F Phillips

S Radford

GORDON MORAN GORDON.MORAN@NOTTINGHAM.AC.UK
Clinical Associate Professor

H A Gonzalez

S Sebastian

F Fousekis

D Christodoulou

Y Snir

Z Lerner

H Yanai

G Michalopoulos

J Tua

L Camilleri

K Papamichael

K Karmiris

K Katsanos

Contributors

GORDON MORAN GORDON.MORAN@NOTTINGHAM.AC.UK
Researcher

Abstract

Introduction and Aim
Post-inflammatory polyps (PIPs) are considered as indicators of previous episodes of severe inflammation and mucosal ulceration. Inflammatory bowel disease (IBD), namely Crohn’s disease (CD) and ulcerative colitis (UC), exhibit a perpetuating, relapsing, and remitting pattern and PIPs is a frequent sequela of chronicity. The aim of this study was to determine whether a high PIPs burden is associated with a more severe disease course in patients with IBD.

Methods
This was a multinational, multicentre, retrospective study. IBD patients previously diagnosed with PIPs were retrieved from the endoscopic database of each centre. PIPs burden was evaluated and associated with demographic and clinical data as well as factors indicating a more unfavorable disease course.

Results
A total of 504 IBD patients with PIPs were recruited (male: 61.9%). The mean age at IBD diagnosis was 36.9 (±16.8) years. Most patients (74.8%) were diagnosed with UC. A high PIPs burden was present in 53.4% of patients. On multivariable Cox regression analysis, high PIPs burden was independently associated with treatment escalation (HR 1.35, 95% CI 1.04-1.75; P=0.024), hospitalization (HR 1.90; 95% CI 1.24 – 2.90; P=0.003), need for surgery (HR 2.28; 95% CI 1.17-4.44, P=0.02) and younger age at diagnosis (HR 0.99, 95% CI 0.98–0,99; p=0.003).

Conclusion
PIPs burden was associated with a more severe outcome. Future prospective studies should focus on the characterisation of PIPs burden as to further risk stratify this patient cohort.

Citation

Ellul, P., Schembri, J., Baldacchino, V. A., Molnar, T., Resal, T., Allocca, M. A., …Katsanos, K. (2022). Post-inflammatory polyps burden as a prognostic marker of disease-outcome in patients with inflammatory bowel disease. Journal of Crohn's and Colitis, https://doi.org/10.1093/ecco-jcc/jjac169

Journal Article Type	Article
Acceptance Date	Nov 9, 2022
Online Publication Date	Nov 2, 2022
Publication Date	Nov 2, 2022
Deposit Date	Nov 9, 2022
Publicly Available Date	Nov 3, 2023
Journal	Journal of Crohn's and Colitis
Print ISSN	1873-9946
Electronic ISSN	1876-4479
Publisher	Oxford University Press
Peer Reviewed	Peer Reviewed
DOI	https://doi.org/10.1093/ecco-jcc/jjac169
Keywords	Gastroenterology; General Medicine
Public URL	https://nottingham-repository.worktribe.com/output/13457152
Publisher URL	https://academic.oup.com/ecco-jcc/advance-article-abstract/doi/10.1093/ecco-jcc/jjac169/6794125