Itabashi Michio    Department   School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine    Position   Professor (Fixed Term)
Article types	Original article
Language	English
Peer review	Non peer reviewed
Title	Effect of Biologics on the Risk of Advanced-Stage Inflammatory Bowel Disease-Associated Intestinal Cancer: A Nationwide Study
Journal	Formal name：The American journal of gastroenterology Abbreviation：Am J Gastroenterol ISSN code：15720241/00029270
Domestic / Foregin	Domestic
Volume, Issue, Page	118(7),pp.1248-1255
Author and coauthor	SEISHIMA Ryo,OKABAYASHI Koji,IKEUCHI Hiroki,UCHINO Motoi,FUTAMI Kitaro,NOGUCHI Tatsuki,OHGE Hiroki,ISEKI Yasuhito,WATANABE Kazuhiro,ITABASHI Michio,OKAMOTO Kinya,TOIYAMA Yuji,OGINO Takayuki,NAKAMURA Masafumi,YAMADA Kazutaka,WAKAI Toshifumi,SATO Yu,KIMURA Hideaki,TAKANASHI Kenichi,HIDE Koya,KINUGASA Yusuke,ISHIDA Fumio,OKUDA Junji,DAITO Koji,KOYAMA Fumikazu,UENO Hideki,YAMAMOTO Takayuki,YAMAMOTO Seiichiro,HANAI Tsunekazu,MEAMOTO Atsuo,ARAKAKI Junya,MKOMORI Koji,AKAGI Yoshito,SHIDA Dai,YAMAGUCHI Shigeki,MATSUDA Keiji,MAEDA Kiyoshi,NOAKE Toshihiro,NEZU Riichiro,SASAKI Shin,HASEGAWA Junichi,SUNAMI Eiji,KANEMITSU Yukihide,KATSUMATA Kenji,UEHARA Kei,KIYOMATSU Tomomichi,SUTO Takeshi,KAZAMA Shinsuke,YAMADA Takeshi,GOI Takenori,ISHIHARA Soichiro,AJIOKA Yoichi,SUGIHARA Kenichi
Publication date	2023/07
Summary	INTRODUCTION:The aim of this study was to evaluate the effect of biologics on the risk of advanced-stage inflammatory bowel disease (IBD)-associated intestinal cancer from a nationwide multicenter data set.METHODS:The medical records of patients with Crohn's disease (CD) and ulcerative colitis (UC) diagnosed with IBD-associated intestinal neoplasia (dysplasia or cancer) from 1983 to 2020 were included in this study. Therapeutic agents were classified into 3 types: biologics, 5-aminosalicylic acid, and immunomodulators. The pathological cancer stage was compared based on the drug used in both patients with CD and UC.RESULTS:In total, 1,042 patients (214 CD and 828 UC patients) were included. None of the drugs were significantly associated with cancer stage in the patients with CD. In the patients with UC, an advanced cancer stage was significantly associated with less use of biologics (early stage: 7.7% vs advanced stage: 2.0%, P < 0.001), 5-aminosalicylic acid, and immunomodulators. Biologic use was associated with a lower incidence of advanced-stage cancer in patients diagnosed by regular surveillance (biologics [-] 24.5% vs [+] 9.1%, P = 0.043), but this was not the case for the other drugs. Multivariate analysis showed that biologic use was significantly associated with a lower risk of advanced-stage disease (odds ratio = 0.111 [95% confidence interval, 0.034-0.356], P < 0.001).DISCUSSION:Biologic use was associated with a lower risk of advanced IBD-associated cancer in patients with UC but not with CD. The mechanism of cancer progression between UC and CD may be different and needs to be further investigated.
DOI	10.14309/ajg.0000000000002149
PMID	36622356