Evidence map›Paper›PMID 40627077›Full record

ArticleJournal of gastroenterology2025

Increasing age at diagnosis raises malignancy risk and aminosalicylate intolerance influences therapeutic strategies in ulcerative colitis: a multicenter I‑BRITE cohort study.

Shintaro Akiyama, Yuka Ito, Mamiko Shiroyama, Satoshi Suzuki, Masanori Ochi, Toshiro Kamoshida, Hiroshi Kashimura, Junichi Iwamoto, Rie Saito, Tsuyoshi Kaneko and 11 more

Abstract readMulticenter Study
PubMed Publisher
In one paragraph

Article in Journal of gastroenterology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Review
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

21 authors.

Shintaro AkiyamaDepartment of Gastroenterology, Institute of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan. akiyama@md.tsukuba.ac.jp.ORCID 0000-0003-0727-7638
Yuka ItoDepartment of Gastroenterology NHO Mito Medical Center, Ibaraki, Japan.
Mamiko ShiroyamaDepartment of Gastroenterology, Institute of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan.
Satoshi SuzukiDepartment of Gastroenterology, Hitachi General Hospital, Ibaraki, Japan.
Masanori OchiDepartment of Gastroenterology, Hitachi General Hospital, Ibaraki, Japan.
Toshiro KamoshidaDepartment of Gastroenterology, Hitachi General Hospital, Ibaraki, Japan.
Hiroshi KashimuraDepartment of Gastroenterology, Mito Saiseikai General Hospital, Ibaraki, Japan.
Junichi IwamotoDepartment of Internal Medicine, Division of Gastroenterology and Hepatology, Tokyo Medical University Ibaraki Medical Center, Ibaraki, Japan.
Rie SaitoDivision of Gastroenterology, Tsukuba Central Hospital, Ibaraki, Japan.
Tsuyoshi KanekoDivision of Gastroenterology, Tsukuba Central Hospital, Ibaraki, Japan.
Kazuto IkezawaDivision of Gastroenterology, Tsukuba Memorial Hospital, Ibaraki, Japan.
Yoshinori HiroshimaDivision of Gastroenterology, Hitachinaka General Hospital, Ibaraki, Japan.
Junji HattoriDepartment of Gastroenterology, Ryugasaki Saiseikai Hospital, Ibaraki, Japan.
Takashi MamiyaDepartment of Gastroenterology, Tsukuba Medical Center Hospital, Ibaraki, Japan.
Satoshi FukudaDepartment of Gastroenterology, Koyama Memorial Hospital, Ibaraki, Japan.
Kazuho IkedaDepartment of Gastroenterology, Koyama Memorial Hospital, Ibaraki, Japan.
Hiroyuki ArigaDepartment of Gastroenterology, Mito Kyodo General Hospital, Ibaraki, Japan.
Junya KashimuraDepartment of Gastroenterology, Mito Kyodo General Hospital, Ibaraki, Japan.
Masaaki NishiDepartment of Gastroenterology, Tsukuba Medical Center Hospital, Ibaraki, Japan.
Masaomi NagaseDepartment of Gastroenterology, Kasumigaura Medical Center, Ibaraki, Japan.
Kiichiro TsuchiyaDepartment of Gastroenterology, Institute of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan. kii.gast@md.tsukuba.ac.jp.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe management and characteristics of ulcerative colitis (UC) have evolved over time. We aimed to clarify how changing clinical profiles and treatment options affect patient outcomes.

methodsThis retrospective multicenter study of 13 hospitals divided diagnostic era into six periods: Era 1 (before June 30, 1998) and five subsequent 5-year intervals, with Era 6 (July 1, 2018-June 30, 2023) representing the most recent period. We compared therapeutic trends and outcomes across diagnostic eras, including the risk of first systemic steroid, advanced therapy (ADT) use, colectomy, UC-associated neoplasia (UCAN), and extracolonic malignancies.

resultsWe included 1,867 UC patients. The proportion of elderly onset cases was significantly higher in Eras 5-6 (13%) compared to Eras 1-4 (0%-8.1%). Aminosalicylate intolerance was significantly more frequent in Era 6 (10%) and was significantly associated with earlier systemic steroid and ADT use, though not with colectomy or UCAN. While prescribing patterns of conventional therapies remained unchanged, the preferred first-line ADT shifted from infliximab to vedolizumab in recent diagnostic years. The cumulative risk of colectomy and UCAN did not significantly differ between eras. However, the cumulative risk of extracolonic malignancy was significantly higher in recent diagnostic years and significantly associated with older age at diagnosis.

conclusionsIn the recent diagnostic era, the increase in elderly onset UC has been accompanied by a higher malignancy risk, favoring vedolizumab as first-line ADT, especially in elderly patients. Increased aminosalicylate intolerance has led to earlier initiation of systemic steroids and ADTs, which may contribute to improved outcomes.

Indexed as

Aminosalicylic AcidsAnti-Inflammatory Agents, Non-SteroidalColitis, UlcerativeNeoplasmsAdultAgedAge FactorsAge of OnsetCohort StudiesColectomyFemaleHumansMaleMiddle AgedRetrospective StudiesRisk FactorsAminosalicylic AcidsAnti-Inflammatory Agents, Non-SteroidalAminosalicylate intoleranceElderly onsetMalignancy riskTherapy sequenceUlcerative colitis

Identifiers

PMID40627077

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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.