ArticleJournal of gastroenterology2020
An update on primary sclerosing cholangitis epidemiology, outcomes and quantification of alkaline phosphatase variability in a population-based cohort.
Article in Journal of gastroenterology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
25 citing papers in PubMed, 3 syntheses or guidelines pooled it, 34 citations in OpenAlex.
- Comparative Outcomes of Primary Sclerosing Cholangitis With and Without Comorbid Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis.Digestive diseases and sciences · 2026Pooled it
- The epidemiological trends and projected future of primary sclerosing cholangitis by 2040: An updated meta-analysis and modeling study.PloS one · 2025Pooled it
- Incidence and Prevalence of Primary Sclerosing Cholangitis: A Meta-analysis of Population-based Studies.Inflammatory bowel diseases · 2024Pooled it
- Cholangiocyte biology in primary sclerosing cholangitis and other cholangiopathies: pathogenesis, clinical insights, and experimental tools.Physiological reviews · 2026Review
- A Dual-Gene Signature of PMAIP1 and GADD45A for Early Detection of Intrahepatic Cholangiocarcinoma in the Context of Primary Sclerosing Cholangitis.International journal of molecular sciences · 2026Article
- Gallbladder neoplasia is associated with a higher incidence of cholangiocarcinoma in patients with primary sclerosing cholangitis.Canadian liver journal · 2026Article
- Large duct primary sclerosing cholangitis with or without inflammatory bowel disease in Saudi patients.Saudi journal of gastroenterology : official journal of the Saudi Gastroenterology Association · 2025Article
- Development of the natural history component of an early economic model for primary sclerosing cholangitis.Orphanet journal of rare diseases · 2025Article
- Primary sclerosing cholangitis.Nature reviews. Disease primers · 2025Review
- Prevalence of primary sclerosing cholangitis (PSC) in Iranian adult patients with inflammatory bowel disease (IBD) or liver disorders: systematic review and meta-analysis.Gastroenterology and hepatology from bed to bench · 2025Review
- Management of primary sclerosing cholangitis: Current state-of-the-art.Hepatology communications · 2024Review
- Noninvasive prognostic models, imaging, and elastography to predict clinical events in primary sclerosing cholangitis: A review.World journal of hepatology · 2023Review
- Anti-integrin αvβ6 autoantibodies in patients with primary sclerosing cholangitis.Journal of gastroenterology · 2023Article
- Living-Donor Liver Transplant and Improved Post-Transplant Survival in Patients with Primary Sclerosing Cholangitis.Journal of clinical medicine · 2023Article
- Protective potential of the gallbladder in primary sclerosing cholangitis.JHEP reports : innovation in hepatology · 2023Article
- Gender and Autoimmune Liver Diseases: Relevant Aspects in Clinical Practice.Journal of personalized medicine · 2022Review
- Soluble Urokinase Plasminogen Activator Receptor Levels Are Associated with Severity of Fibrosis in Patients with Primary Sclerosing Cholangitis.Journal of clinical medicine · 2022Article
- Reporting standards for primary sclerosing cholangitis using MRI and MR cholangiopancreatography: guidelines from MR Working Group of the International Primary Sclerosing Cholangitis Study Group.European radiology · 2022Article
- Fluctuating biomarkers in primary sclerosing cholangitis: A longitudinal comparison of alkaline phosphatase, liver stiffness, and ELF.JHEP reports : innovation in hepatology · 2021Article
- Cholangiocarcinoma and liver transplantation: What we know so far?World journal of gastrointestinal pathophysiology · 2021Review
Corrections and comments
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Authors and funding
10 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundContemporary primary sclerosing cholangitis (PSC) population-based cohorts describing the epidemiology, natural history, and long-term fluctuations in serum alkaline phosphatase (SAP) and their prognostic relevance are lacking. Therefore, we investigated the incidence and natural history of PSC and quantified SAP fluctuations among those with PSC in Olmsted County, Minnesota over the last 41 years.
methodsThe Rochester Epidemiology Project was used to identify 56 subjects diagnosed with PSC between 1976 and 2017 in Olmsted County. The primary endpoint (n = 19) included liver transplantation, hepatic decompensation, and cholangiocarcinoma.
resultsThe age- and sex-adjusted incidence of PSC (per 100,000 person years) nearly doubled from 2001 to 2017 compared to 1976-2000 (1.47; 95% CI 0.99-1.96 versus 0.79; 95% CI 0.42-1.16, p = 0.02). This increase paralleled a rise in patients with markers of a milder phenotype at the time of diagnosis: normal SAP (26.32% versus 0%, p < 0.01) and lower Mayo PSC risk score [0.36 (- 0.57 to 1.55) versus - 0.50 (- 1.25 to 0.35), p = 0.03]. Intra-individual SAP fluctuates with a median coefficient of variation of 36.20%. SAP normalization and dropping below 1.5 × upper limit of normal (ULN) occurs at a rate of 5% and 10% per year, respectively. SAP less than 1.5 × ULN was associated with a lower risk of PSC-related complications (hazard ratio 0.11; 95% CI 0.03-0.42).
conclusionsThe patients with PSC are increasingly being diagnosed with a milder phenotype. While a lower SAP is associated with improved outcomes, the high intra-individual variation of SAP levels calls into question the practice of using a single SAP value as a surrogate endpoint in clinical trials.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.