{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T22:36:24Z","timestamp":1787697384687,"version":"build-2784847793"},"reference-count":32,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2022,7,4]],"date-time":"2022-07-04T00:00:00Z","timestamp":1656892800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Patients with primary sclerosing cholangitis (PSC) and inflammatory bowel disease (IBD) are at risk of biliary tract cancer and liver damage (possibly leading to liver transplantation), and are often treated for IBD with thiopurines and\/or tumour necrosis factor antagonists (anti\u2010TNF) on a long\u2010term basis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To assess the risk of biliary tract cancer and liver transplantation in patients exposed to thiopurines and\/or anti TNF agents in a French nationwide cohort.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed a population\u2010based study of patients aged 18\u2009years or older with PSC and IBD in the French national health insurance database. Patients were followed from 1 January 2009 to 31 December 2018. The risks of biliary tract cancer and liver transplantation associated with thiopurines and anti\u2010TNF exposure were assessed with marginal structural Cox proportional hazard models, adjusting for baseline demographics and comorbidities, and time\u2010varying medications and PSC activity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among the 1929 patients with PSC and IBD included, 37 biliary tract cancers and 83 liver transplantations occurred. Compared with patients not exposed to thiopurines or anti\u2010TNF agents, patients exposed to thiopurines (hazard ratio [HR], 1.05; 95% confidence interval [CI], 0.39\u20132.82) or anti\u2010TNF agents (HR, 0.59; 95% CI, 0.13\u20132.80) had no excess risk of biliary tract cancer. Similarly, patients exposed to thiopurines (HR, 0.67; 95% CI, 0.30\u20131.48) or anti\u2010TNF agents (HR, 0.68; CI, 0.22\u20132.09) had no excess risk of liver transplantation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Patients with PSC and IBD who are exposed to thiopurines or anti\u2010TNF agents are not at excess risk of biliary tract cancer or liver transplantation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.17123","type":"journal-article","created":{"date-parts":[[2022,7,5]],"date-time":"2022-07-05T04:49:35Z","timestamp":1656996575000},"page":"857-868","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Impact of thiopurines and tumour necrosis factor antagonists on primary sclerosing cholangitis outcomes in patients with inflammatory bowel disease"],"prefix":"10.1111","volume":"56","author":[{"given":"Am\u00e9lie","family":"Biron","sequence":"first","affiliation":[{"name":"Sorbonne Universit\u00e9, INSERM, Institut Pierre Louis d\u2019Epid\u00e9miologie et de Sant\u00e9 Publique, AP\u2010HP, H\u00f4pital Saint\u2010Antoine, Department of Gastroenterology  Paris France"},{"name":"Department of Gastroenterology Reims University Hospital, H\u00f4pital Robert Debre  Reims France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurent","family":"Beaugerie","sequence":"additional","affiliation":[{"name":"Sorbonne Universit\u00e9, INSERM, Institut Pierre Louis d\u2019Epid\u00e9miologie et de Sant\u00e9 Publique, AP\u2010HP, H\u00f4pital Saint\u2010Antoine, Department of Gastroenterology  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivier","family":"Chazouill\u00e8res","sequence":"additional","affiliation":[{"name":"Department of Hepatology, Saint\u2010Antoine Hospital, Assistance Publique \u2013 H\u00f4pitaux de Paris, INSERM Saint\u2010Antoine Research Center, Reference Center for Inflammatory Biliary Diseases and Autoimmune Hepatitis, French Network for Rare Liver Diseases (FILFOIE), European Reference Network on Hepatological Diseases (ERN RARE\u2010LIVER) Sorbonne University  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2314-9284","authenticated-orcid":false,"given":"Julien","family":"Kirchgesner","sequence":"additional","affiliation":[{"name":"Sorbonne Universit\u00e9, INSERM, Institut Pierre Louis d\u2019Epid\u00e9miologie et de Sant\u00e9 Publique, AP\u2010HP, H\u00f4pital Saint\u2010Antoine, Department of Gastroenterology  Paris 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