Analysis of 1776 Patients with Primary Sclerosing Cholangitis from a Laboratory Database F

Analysis of 1776 Patients with Primary Sclerosing Cholangitis from a Laboratory Database F. Mittermayer1, S. Jones2, M. Jones2 and C. Filozof3 Covance, 1Vienna, Austria; 2Maidenhead, United Kingdom; 3Madrid, Spain

Introduction Results Conclusions The ICD-10 is an international standard for defining and reporting ▶ The mean age of the patients was 49 years (SD 18), 44.1% ▶ Consistent with previous reports the rate of fibrosis and liver diseases and health conditions. Most of the epidemiologic data were female. cirrhosis was lower in PSC patients with concomitant Crohn’s available in Primary Sclerosing Cholangitis (PSC), a rare disease than in those without. ▶ Alkaline phosphatase (ALP) levels were elevated >ULN in cholestatic liver disease, originate from a period before the new 69.7% of the patients and were >1.5 x ULN in 52.7% of the ▶ The proportion of women with PSC in this database was higher ICD 10 code K83.01 was available. patients. than the one reported in other studies. Additional analysis of the reasons for the higher proportion of women with PSC in this ▶ Inflammatory bowel disease (IBD) was reported in 25.7% Aim database is warranted. (ulcerative colitis 19.0%, Crohn’s disease 6.7%). The aim of the current analysis was to characterize patients with ▶ Availability of a large clinical laboratory database may add ▶ Other concomitant diagnoses with a frequency >5% were: the PSC specific ICD 10 code K83.01 with regards to age, sex and value when assessing PSC patient characteristics. ALP levels as well as associated co-morbidities according to ICD- – fibrosis and cirrhosis of the liver (10%) codes reported by the referring health care providers: K50 (Crohn’s – abnormal serum enzyme levels (6.4%) ▶ Limitations: Due to the nature of the database the results are disease), K51 (ulcerative colitis), K74 (fibrosis and cirrhosis of the – other inflammatory liver disease (6.1%) limited by the fact that reporting diagnosis codes by referring health care providers may be incomplete and/or incorrect in liver), K75.4 (autoimmune hepatitis) and others. – abnormal results of function studies (5.7%) some cases. ▶ A comparison between female and male patients (mean age Method 51 vs. 47 years) revealed: A clinical laboratory database maintained by LabCorp was utilized – a higher prevalence of ulcerative colitis in males (21.6% Reference to assess comorbidity and laboratory data of 1776 PSC patients vs. 15.7%) Weismüller TJ et al. Patient Age, Sex, and Inflammatory Bowel Disease – a slightly higher rate of reported fibrosis and cirrhosis of from the United States who were seen by a healthcare provider Phenotype Associate With Course of Primary Sclerosing Cholangitis. between 1 Oct 2018 and 31 Aug 2019. The earliest complete the liver in males (10.8% vs. 8.9%) Gastroenterology 2017;152: 1975-1984. assessment per patient was included in the analysis if more than – ALP and other laboratory parameters were comparable one was present. between the sexes ▶ Patients with IBD had a lower rate of reported fibrosis and Table 1. Female and Male Patients with PSC cirrhosis of the liver (7.2 vs. 10.9%). This was mainly Table 2. Patients with IBD and PSC attributable to a lower rate of the ICD10 code K74 in No No Female Male patients with Crohn’s disease compared to patients without Crohn’s Ulcerative Crohn’s Ulcerative Crohn’s disease (4.2 vs. 10.4%). The highest prevalence of Disease Colitis Age in yrs ± SD (n) 51±18 (783) 47±18 (993) Disease Colitis fibrosis and cirrhosis of the liver was seen in 99 patients with concomitant autoimmune hepatitis compared to Age in yrs ± 49 ± 18 50 ± 18 41 ± 17 (119) 44 ± 18 (337) Ulcerative colitis 123 (15.7%) 214 (21.6%) patients without an ICD code of autoimmune hepatitis SD (n) (1657) (1439) reported (16.3 vs. 9.6%). Liver fibrosis Crohn’s disease 50 (6.4%) 69 (6.9% 5 (4.2%) 172 (10.4%) 28 (8.3%) 149 (10.4%) and cirrhosis Liver fibrosis and 70 (8.9%) 107 (10.8%) cirrhosis ALP > ULN 53 (60.2%) 919 (70.3%) 201 (72.0%) 771 (69.1%) ALP > 1.5 x ALP > ULN 425 (69.2%) 547 (70.0%) 43 (48.9%) 692 (52.9%) 149 (53.4%) 586 (52.5%) ULN ALP > 1.5 x ULN 314 (51.1%) 421 (53.9%)

Presented at EASL 2020