Rates of Refractory Celiac Disease Down Sharply in Last 25 Years

Celiac.com 01/30/2017 - A team of researchers recently set out to analyze potential changes in occurrence of complicated coeliac disease over the last 25 years.

The research team included W. Eigner, K. Bashir, C. Primas, L. Kazemi-Shirazi, F. Wrba, M. Trauner, and H. Vogelsang. They are variously affiliated with the Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University Hospital of Vienna, Vienna, Austria, and with the Department of Pathology at the Medical University of Vienna in Vienna, Austria.

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The team included and evaluated a total of 1,138 patients based on time of first presentation at the Medical University of Vienna, Austria.

They assessed occurrences of refractory celiac disease and associated malignancies in 5-year intervals from January 1990 until December 2014, and then compared results over time. Twenty-nine patients, or 2.6%, were diagnosed with refractory celiac disease. Of these, 65.6% were females averaging 62.8 years of age at diagnosis.

The proportion of those patients was 2.6%, 3.1%, 3.3%, 2.7% and 0.5% for the 5 year intervals from 1990 through 2014. The number of refractory cases has been generally decreasing since 2000 (P = 0.024). During that time, a total of seven patients presented with lymphoma, totaling 0.6%, 0.4%, 1.1%, 0.8% and 0% of patients each year, respectively.

Similarly the number of patients with adenocarcinoma, four patients total, decreased to 0% until 2014. Nearly 50% of patients suffering from refractory disease died during the study period. Meanwhile, 71.4% all patients diagnosed with lymphoma died, with a 5-year survival rate of 28.6%.

Over the past 15 years, rates of complicated celiac disease have been decreasing. This may be due to increased celiac disease awareness, along with optimized diagnosis and treatment with avoidance of long-term immunological disease activity.

Known risk factors for refractory celiac disease and related cancer include untreated symptomatic disease and delayed diagnosis.

Source:

• Aliment Pharmacol Ther, 45: 364–372. doi:10.1111/apt.13867