Treatment of Primary Sclerosing Cholangitis with Concomitant Inflammatory Bowel Disease
Primary sclerosing cholangitis (PSC) frequently occurs alongside inflammatory bowel disease (IBD). This co-occurrence shapes clinical priorities and requires IBD management that accounts for the hepatobiliary context.
Clinical Scenario
This protocol addresses patients with primary sclerosing cholangitis who have concomitant inflammatory bowel disease. IBD management in the setting of PSC follows current practice guidelines, with particular attention to colorectal cancer risk — a consideration that influences therapeutic choices in this population.
Treatment Approach
PSC-related IBD is treated in accordance with current practice guidelines. One component of the approach involves an aminosalicylate therapy for colitis, chosen in part for its role in reducing colorectal cancer and dysplasia risk in this specific population. The full protocol covers the complete selection and sequencing.
Clinical Goal
The primary treatment target is mucosal healing, evaluated through objective measures including endoscopy and faecal calprotectin.
References
DOI: 10.1016/j.jhep.2022.05.011
- Treatment of PSC-related IBD in line with current practice guidelines with the goal of achieving mucosal healing is recommended.
- 5-aminosalicylic acid is recommended in colitis because it reduces the risk of development of colorectal cancer/dysplasia.
- Objective measures of mucosal healing, such as endoscopy and/or measurements of faecal calprotectin, are therefore recommended.