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High dose ursodeoxycholic acid in primary sclerosing cholangitis does not prevent colorectal neoplasia
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2012 (English)In: Alimentary Pharmacology and Therapeutics, ISSN 0269-2813, E-ISSN 1365-2036, Vol. 35, no 4, 451-457 p.Article in journal (Refereed) Published
Abstract [en]

Background: Patients with primary sclerosing cholangitis (PSC) and inflammatory bowel disease (IBD) have a high risk of developing colorectal cancer and dysplasia. Ursodeoxycholic acid (UDCA) has been suggested to have chemopreventive effects on the development of colorectal cancer and dysplasia but long-term data and larger trials are lacking.

Aim: To evaluate the effect of high dose (17-23 mg/kg/day) UDCA on colorectal neoplasia in a cohort of patients with PSC and IBD.

Methods: From our previous 5-year randomised controlled trial of UDCA vs. placebo in PSC, we performed a follow-up of 98 patients with concomitant IBD from entry of the trial 1996-1997 until 2009 for development of colorectal cancer or dysplasia.

Results: The total follow-up time was 760 person-years. Dysplasia/cancer-free survival was compared between placebo-(n = 50) and UDCA-treated (n = 48) patients. There was a similar frequency of dysplasia or cancer after 5 years between patients originally assigned to UDCA or placebo (13% vs. 16%) and no difference in dysplasia/cancer-free survival (P = 0.46, log rank test). At the end of 2009 no difference in cancer-free survival was detected, 30% of the placebo patients compared with 27% of UDCA patients had developed colorectal cancer or dysplasia.

Conclusions: Long-term high dose ursodeoxycholic acid does not prevent colorectal cancer or dysplasia in patients with primary sclerosing cholangitis-associated inflammatory bowel disease.

Place, publisher, year, edition, pages
Malden: Wiley-Blackwell, 2012. Vol. 35, no 4, 451-457 p.
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Gastroenterology and Hepatology
URN: urn:nbn:se:umu:diva-52644DOI: 10.1111/j.1365-2036.2011.04966.xISI: 000299154900005OAI: diva2:506816
Available from: 2012-03-01 Created: 2012-02-28 Last updated: 2012-03-01Bibliographically approved

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