AI Article Synopsis
- Primary sclerosing cholangitis (PSC) is a significant concern in Europe as it is linked to liver transplants and cancer risk in people with inflammatory bowel disease (IBD); this study aims to examine the trends in prevalence and forecast future changes in PSC and IBD among adults in England.
- Data was analyzed from a national healthcare registry to determine the prevalence rates of PSC with IBD from 2015 to 2020, and predictions were made for 2021-2027 based on current trends and survival rates.
- The findings indicate that the prevalence of PSC associated with IBD is expected to grow faster than that of IBD alone, highlighting the need for further
Article Abstract
Background: Primary sclerosing cholangitis (PSC) is one of the leading indications for liver transplantation in Europe, and a major risk factor for cancer in inflammatory bowel disease (IBD). However, it is not known how the epidemiology of PSC will change as that of IBD evolves. The aim of this study is to provide nationwide statistics on the past and current prevalence of PSC and IBD across England, and forecast how this is likely to change over time.
Methods: We accessed and analysed a nationwide population-based administrative healthcare registry, which houses prospectively accrued data since April 1st 2001. In so doing, the past and current prevalence of PSC-IBD and IBD alone was determined among 18-60-year-olds in England, alongside average annual percentage change rates (AAPC), between the 1st of January 2015 and 2020. Past and current prevalence data, alongside trends in incidence and event-free survival rates, were then used to forecast future prevalence between 2021 and 2027.
Findings: In 2015, the prevalence of PSC with prior IBD diagnosis was 5.0 per 100,000 population, rising to 5.7 when including those with IBD diagnosed after PSC. In 2020, prevalence increased to 7.6 (8.6 accounting for IBD developing after PSC), yielding an AAPC of 8.8. In 2027, PSC-IBD prevalence is forecast to be 11.7 (95% prediction interval [PI]: 10.8-12.7), and 13.3 when accounting for IBD developing after PSC (AAPC: 6.4; 95% PI: 5.3-7.5). Comparatively, the prevalence of IBD alone rose among 18-60-year-olds from 384.3 in 2015 to 538.7 in 2020 (AAPC 7.0), and forecast to increase to 742.5 by 2027 (95% PI: 736.4-748.0; AAPC: 4.7, 95% PI: 4.6-4.8).
Interpretation: The rate of growth in PSC-IBD is predicted to exceed IBD-alone. Further research is needed to understand changes in disease epidemiology, including aetiological drivers of developing (invariably progressive) liver disease in IBD, and the implications of rising case burden on health care resources.
Funding: This study was supported by an unrestricted grant provided by Gilead Sciences.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11296053 | PMC |
| http://dx.doi.org/10.1016/j.lanepe.2024.101002 | DOI Listing |
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