JCC: Post-inflammatory polyp load can be used as a prognostic marker for disease outcomes in patients with inflammatory bowel disease

Post-inflammatory polyps (PIPs) are polyp-like structures that protrude above mucosal surfaces but have no malignant potential
.
We usually use the term "inflammatory polyp" or "pseudopolyp"
.
Patients with inflammatory bowel disease (IBD) often develop colonic PIP, and the prevalence of ulcerative colitis (UC) has been reported to be twice as high as that of colonic Crohn's disease (CD
).
PIP in IBD is associated with
more severe inflammation, higher colectomy rates, and greater need for biological therapy.
Patients with IBD with PIP had an increased risk of CRC compared with those without PIP (odds ratio [OR] 2.
01; 95% confidence interval [CI] 1.
43–2.
83).

Therefore, the aim of this study was to determine whether high PIPs burden is associated with a more severe course in people with
IBD.

This study is a cross-national, multicentre, retrospective study
.
The researchers searched IBD patients
with a previous diagnosis of PIP from the endoscopic database at each center.
The burden of PIPs was assessed and correlated with demographic and clinical data and factors indicating a more adverse disease process
.

A total of 504 IBD patients (men: 61.
9%)
with PIPs were enrolled.
The average age at diagnosis of IBD was 36.
9 years
.
The majority of patients (74.
8%) were diagnosed with UC.

High PIPs burden
was present in 53.
4% of patients.
In multivariate Cox regression analysis, high PIPs burden was associated with treatment escalation (HR 1.
35, 95% CI 1.
04-1.
75; P = 0.
024), increased hospitalization (HR 1.
90; 95% CI 1.
24 to 2.
90; P=0.
003), and need for surgery (HR 2.
28; 95% CI 1.
17-4.
44, P=0.
02) and younger diagnosis (HR 0.
99, 95% CI 0.
98-0,99; p=0.
003).

This study confirms that the burden of PIPs is associated with
more severe outcomes.
Therefore, future prospective studies should focus on the characteristics of the burden of PIPs to further stratify
the risk of this patient cohort.

Original source:

P Ellul.
et al.
Post-inflammatory polyps burden as a prognostic marker of disease-outcome in patients with inflammatory bowel disease.
Journal of Crohn's and Colitis.
2022.