Evaluation of non-alcoholic fatty liver disease in patients with inflammatory bowel disease using controlled attenuation parameter technology: A Taiwanese retrospective cohort study

Yen, Hsu‐Heng; Su, Pei–Yuan; Huang, Siou‐Ping; Wu, Lijuan; Hsu, Tsui-Chun; Zeng, Ya-Huei; Chen, Yang‐Yuan

doi:10.1371/journal.pone.0252286

Cited by 25 publications

(51 citation statements)

References 39 publications

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“…There were 15 studies that reported the prevalence of NAFLD according to sex 5,6,13,24,30,31,33,35,37–39,42,48,53,54 . Overall, the pooled prevalence was higher in men with IBD (33.2%, 95% CI 25.5–40.9; I 2 = 96.0%; p <0.001) compared with women (27.0%, 95% CI 20.5–33.4; I 2 = 93.3%; p <0.001) (Table 1).…”

Section: Resultsmentioning

confidence: 99%

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Meta‐analysis: prevalence of, and risk factors for, non‐alcoholic fatty liver disease in patients with inflammatory bowel disease

Zamani

Alizadeh-Tabari

Singh

et al. 2022

Aliment Pharmacol Ther

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Summary Background Non‐alcoholic fatty liver disease (NAFLD) is found in inflammatory bowel disease (IBD). However, uncertainties remain on the magnitude of the association. Aims To explore systematically the prevalence of, and risk factors for, NAFLD in IBD patients. Methods We searched medical literature using Embase, PubMed, Web of Science, Scopus and ProQuest, from inception to September 30, 2021. We included observational studies reporting the prevalence of NAFLD in ≥50 adult patients with IBD. Diagnosis of NAFLD could be based on imaging, histopathology, and/or hepatic steatosis index. Sex, age, body mass index (BMI), diabetes, hypertension, dyslipidemia, prior surgery (bowel resection), corticosteroids, biologics and immunomodulators were assessed as potential risk factors for NAFLD. Results Of 1893 citations, 44 eligible studies were finally included, comprising 14 947 subjects from 18 different countries. Pooled prevalence of NAFLD was 30.7% (95% confidence interval [CI] 26.5–34.9) in patients with IBD worldwide, which varied regionally. No significant difference was observed in the odds ratio (OR) of NAFLD among Crohn’s disease (CD) patients compared with ulcerative colitis (UC) patients (1.16, 95% CI 0.93–1.44). Risk of NAFLD was almost twice as high in patients with IBD as in healthy subjects (OR 1.96, 95% CI 1.13–3.41). Age (adjusted OR 1.03, 95% CI 1.01–1.05) and BMI (adjusted OR 1.27, 95% CI 1.22–1.32) were statistically significantly associated with increased risk of NAFLD. The pooled prevalence of advanced liver fibrosis in IBD patients with NAFLD was 13.6% (95% CI 7.6–19.7) based on six studies. Conclusion Up to one‐third of patients with IBD experienced NAFLD worldwide. The risk of NAFLD was two times higher in IBD patients versus healthy subjects.

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Section: Resultsmentioning

confidence: 99%

“…There were 15 studies that reported the prevalence of NAFLD according to sex. 5,6,13,24,30,31,33,35,[37][38][39]42,48,53,54 Overall, the pooled prevalence was higher in men with IBD (33.2%, 95% CI 25. 1).…”

Section: Pooled Prevalence Of Nafld In Patients With Ibd According To...mentioning

confidence: 99%

Meta‐analysis: prevalence of, and risk factors for, non‐alcoholic fatty liver disease in patients with inflammatory bowel disease

Zamani

Alizadeh-Tabari

Singh

et al. 2022

Aliment Pharmacol Ther

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“…In the literature, the prevalence of NAFLD in patients with IBD is variable. Two recent meta-analyses reported a pooled prevalence of NAFLD in IBD of 27.5%[ 75 ] and 32%[ 76 ]; older age, obesity, type 2 diabetes, longer IBD duration and previous surgery were the main risk factors associated with the development of NAFLD[ 77 ]. A further meta-analysis specifically addressing the role of IBD treatment on the risk of NAFLD found no significant association between medications of all types ( i.e.…”

Section: Non-immune-mediated Disordersmentioning

confidence: 99%

Liver-side of inflammatory bowel diseases: Hepatobiliary and drug-induced disorders

Mazza¹,

Soro²,

Verga³

et al. 2021

WJH

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Hepatobiliary disorders are among the most common extraintestinal manifestations in inflammatory bowel diseases (IBD), both in Crohn’s disease and ulcerative colitis (UC), and therefore represent a diagnostic challenge. Immune-mediated conditions include primary sclerosing cholangitis (PSC) as the main form, variant forms of PSC (namely small-duct PSC, PSC-autoimmune hepatitis overlap syndrome and IgG4-related sclerosing cholangitis) and granulomatous hepatitis. PSC is by far the most common, presenting in up to 8% of IBD patients, more frequently in UC. Several genetic foci have been identified, but environmental factors are preponderant on disease pathogenesis. The course of the two diseases is typically independent. PSC diagnosis is based mostly on typical radiological findings and exclusion of secondary cholangiopathies. Risk of cholangiocarcinoma is significantly increased in PSC, as well as the risk of colorectal cancer in patients with PSC and IBD-related colitis. No disease-modifying drugs are approved to date. Thus, PSC management is directed against symptoms and complications and includes medical therapies for pruritus, endoscopic treatment of biliary stenosis and liver transplant for end-stage liver disease. Other non-immune-mediated hepatobiliary disorders are gallstone disease, whose incidence is higher in IBD and reported in up to one third of IBD patients, non-alcoholic fatty liver disease, pyogenic liver abscess and portal vein thrombosis. Drug-induced liver injury (DILI) is an important issue in IBD, since most IBD therapies may cause liver toxicity; however, the incidence of serious adverse events is low. Thiopurines and methotrexate are the most associated with DILI, while the risk related to anti-tumor necrosis factor-α and anti-integrins is low. Data on hepatotoxicity of newer drugs approved for IBD, like anti-interleukin 12/23 and tofacitinib, are still scarce, but the evidence from other rheumatic diseases is reassuring. Hepatitis B reactivation during immunosuppressive therapy is a major concern in IBD, and adequate screening and vaccination is warranted. On the other hand, hepatitis C reactivation does not seem to be a real risk, and hepatitis C antiviral treatment does not influence IBD natural history. The approach to an IBD patient with abnormal liver function tests is complex due to the wide range of differential diagnosis, but it is of paramount importance to make a quick and accurate diagnosis, as it may influence the therapeutic management.

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“…However, HCV treatment has been revolutionized recently by the introduction of direct-acting antiviral (DAA) therapy, which has a high treatment success rate and safety profile. The Taiwanese health care system has been reimbursing these new agents since 2017, and the government has set the goal of obtaining an 80% treatment coverage rate with DAAs by 2025 [1, [6][7][8][9][10]. Nevertheless, the treatment of patients with compensated cirrhosis is challenging in the early developmental stage of DAAs.…”

Section: Introductionmentioning

confidence: 99%

Real-World Experience of Chronic Hepatitis C-Related Compensated Liver Cirrhosis Treated with Glecaprevir/Pibrentasvir: A Multicenter Retrospective Study

Chen

Lai

et al. 2021

JCM

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Background: Glecaprevir/pibrentasvir is a protease inhibitor-containing pangenotypic direct-acting antiviral regimen that has been approved for the treatment of chronic hepatitis C. The present study aimed to evaluate the safety and efficacy of glecaprevir/pibrentasvir in patients with compensated cirrhosis in a real-world setting. Methods: We evaluated the real-world safety and efficacy of glecaprevir/pibrentasvir in patients with compensated cirrhosis from five hospitals in the Changhua Christian Care System, who underwent treatment between August 2018 and October 2020. The primary endpoint was a sustained virological response observed 12 weeks after completion of the treatment. Results: Ninety patients, including 70 patients who received the 12-week therapy and 20 patients who received the 8-week therapy, were enrolled. The mean age of the patients was 65 years, and 57.8% of the patients were males. Sixteen (17.8%) patients had end-stage renal disease, and 15 (16.7%) had co-existing hepatoma. The hepatitis C virus genotypes 1 (40%) and 2 (35.6%) were most common. The common side effects included anorexia (12.2%), pruritus (7.8%), abdominal discomfort (7.8%), and malaise (7.8%). Laboratory adverse grade ≥3 events included anemia (6.3%), thrombocytopenia (5.1%), and jaundice (2.2%). The overall sustained virological response rates were 94.4% and 97.7% in the intention-to-treat and per-protocol analyses, respectively. Conclusions: the glecaprevir/pibrentasvir treatment regimen was highly effective and well tolerated among patients with compensated cirrhosis in the real-world setting.

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Evaluation of non-alcoholic fatty liver disease in patients with inflammatory bowel disease using controlled attenuation parameter technology: A Taiwanese retrospective cohort study

Cited by 25 publications

References 39 publications

Meta‐analysis: prevalence of, and risk factors for, non‐alcoholic fatty liver disease in patients with inflammatory bowel disease

Meta‐analysis: prevalence of, and risk factors for, non‐alcoholic fatty liver disease in patients with inflammatory bowel disease

Liver-side of inflammatory bowel diseases: Hepatobiliary and drug-induced disorders

Real-World Experience of Chronic Hepatitis C-Related Compensated Liver Cirrhosis Treated with Glecaprevir/Pibrentasvir: A Multicenter Retrospective Study

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