{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T16:51:48Z","timestamp":1789577508918,"version":"build-2803163510"},"reference-count":40,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,8,22]],"date-time":"2026-08-22T00:00:00Z","timestamp":1787356800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,8,22]],"date-time":"2026-08-22T00:00:00Z","timestamp":1787356800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background &amp; Aims<\/jats:title>\n                    <jats:p>Given the likely underestimation of hepatic sarcoidosis, the aims were to evaluate long\u2010term cirrhosis risk in patients with sarcoidosis without documented hepatic involvement at baseline and to assess the impact of multi\u2010organ disease and immunomodulatory therapies on cirrhosis risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective cohort study using the Clalit Health Services database in Israel included adults with sarcoidosis without documented hepatic involvement or prevalent cirrhosis and age\u2010 and sex\u2010matched controls. The primary outcome was incident cirrhosis, analysed with inverse\u2010probability\u2010of\u2010treatment\u2010weighted (IPTW) Fine\u2010Gray modelling with death as a competing risk. Secondary analyses evaluated multi\u2010organ involvement using landmark methods and immunomodulatory therapies as time\u2010varying exposures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 5489 sarcoidosis patients and 6016 controls (142\u2009002 person\u2010years), cirrhosis occurred in 112 (2.0%) and 38 (0.6%), respectively (incidence rate 1.61 vs. 0.53 per 1000 person\u2010years; rate ratio 3.05). In the primary IPTW\u2010weighted Fine\u2010Gray analysis, sarcoidosis was associated with incident cirrhosis (subdistribution hazard ratio [sHR] 2.84, 95% confidence interval [CI] 1.97\u20134.11,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001); the weighted 20\u2010year cumulative incidence was 2.8% versus 1.1%. The association was consistent across IPTW\u2010weighted cause\u2010specific, covariate\u2010adjusted and follow\u2010up\u2010truncated analyses (hazard ratio [HR]\/sHR range 2.71\u20132.84). Among patients with confirmed organ involvement, 1057 had single\u2010organ and 87 had multi\u2010organ disease. In the 5\u2010year landmark analysis (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009940; 18 events), multi\u2010organ involvement was associated with cirrhosis in the parsimonious model (HR 5.33, 95% CI 1.90\u201315.00,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002). No immunomodulatory therapy was significantly associated with cirrhosis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Sarcoidosis was independently associated with increased cirrhosis risk despite no hepatic involvement, particularly in multiorgan disease. This supports a risk\u2010stratified spectrum from heightened clinical awareness to closer hepatic surveillance in selected patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/liv.70849","type":"journal-article","created":{"date-parts":[[2026,8,22]],"date-time":"2026-08-22T09:24:51Z","timestamp":1787390691000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Cirrhosis Risk in Sarcoidosis Without Documented Hepatic Involvement\u2014A Large Nationwide Population\u2010Based Cohort Study"],"prefix":"10.1111","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1436-1133","authenticated-orcid":false,"given":"Uria","family":"Shani","sequence":"first","affiliation":[{"name":"Internal Medicine Department B Sheba Medical Center  Ramat\u2010Gan Israel"},{"name":"The Center for Liver Diseases Chaim Sheba Medical Center  Ramat Gan 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