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Post-inflammatory Polyp Burden as a Prognostic Marker of Disease-outcome in Patients with Inflammatory Bowel Disease

Ellul, Pierre; Schembri, John; Vella Baldacchino, Andrea; Molnár, Tamas; Resal, Tamas; Allocca, M A; Furfaro, Federica; Buono, Arianna Dal; Theodoropoulou, Angeliki; Fragaki, Maria; Tsoukali, Emmanouela; Mantzaris, Gerassimos J.; Phillips, Frank M.; Radford, Shellie; Moran, Gordon; Gonzalez, H A; Sebastian, Shaji; Fousekis, Fotios; Christodoulou, Dimitrios; Snir, Ifat; Lerner, Zlata; Yanai, Henit; Michalopoulos, Georgios; Tua, Julia; Camilleri, Liberato; Papamichael, Kostas; Karmiris, Konstantinos; Katsanos, Konstantinos

Authors

Pierre Ellul

John Schembri

Andrea Vella Baldacchino

Tamas Molnár

Tamas Resal

M A Allocca

Federica Furfaro

Arianna Dal Buono

Angeliki Theodoropoulou

Maria Fragaki

Emmanouela Tsoukali

Gerassimos J. Mantzaris

Frank M. Phillips

GORDON MORAN GORDON.MORAN@NOTTINGHAM.AC.UK
Professor of Gastroenterology

H A Gonzalez

Shaji Sebastian

Fotios Fousekis

Dimitrios Christodoulou

Ifat Snir

Zlata Lerner

Henit Yanai

Georgios Michalopoulos

Julia Tua

Liberato Camilleri

Kostas Papamichael

Konstantinos Karmiris

Konstantinos Katsanos



Contributors

Abstract

BACKGROUND AND AIMS: 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 are a frequent sequela of chronicity. The aim of this study was to determine whether a high PIP 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. PIP burden was evaluated and associated with demographic and clinical data as well as factors indicating a more unfavourable 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 PIP burden was present in 53.4% of patients. On multivariable Cox regression analysis, a high PIP burden was independently associated with treatment escalation (hazard ratio [HR] 1.35, 95% confidence interval [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: PIP burden was associated with a more severe outcome. Future prospective studies should focus on the characterization of PIP burden as to further risk stratify this patient cohort.

Citation

Ellul, P., Schembri, J., Vella Baldacchino, A., Molnár, T., Resal, T., Allocca, M. A., …Katsanos, K. (2023). Post-inflammatory Polyp Burden as a Prognostic Marker of Disease-outcome in Patients with Inflammatory Bowel Disease. Journal of Crohn's and Colitis, 17(4), 489-496. 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 2023-04
Deposit Date Nov 9, 2022
Publicly Available Date Mar 29, 2024
Journal Journal of Crohn's and Colitis
Print ISSN 1873-9946
Electronic ISSN 1876-4479
Publisher Oxford University Press (OUP)
Peer Reviewed Peer Reviewed
Volume 17
Issue 4
Pages 489-496
DOI https://doi.org/10.1093/ecco-jcc/jjac169
Keywords Post-inflammatory polyps, pseudo polyps, colorectal cancer, inflammatory bowel disease, Crohn’s disease, ulcerative colitis
Public URL https://nottingham-repository.worktribe.com/output/13457152
Publisher URL https://academic.oup.com/ecco-jcc/article-abstract/17/4/489/6794125

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