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 17 December 2017

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News

Routine biopsy after diagnosis does not affect long-term outcomes in celiac disease

Performing routine follow-up biopsy 1 year after diagnosis does not affect long-term outcomes in celiac disease, reports the latest issue of the Alimentary Pharmacology & Therapeutics.

News image

A repeat biopsy is recommended, but often omitted in celiac disease patients on a gluten-free diet. 

The effect of performing or not performing repeat biopsies is currently unknown.

Dr Kurppa and colleagues from Finland identified factors associated with and the significance of lacking biopsy for long-term outcome. 

Predictors and the importance of incomplete histological recovery after 1 year was investigated in re-biopsied patients.

A total of 760 patients participated in a nationwide follow-up study. 

Medical data were gathered via interviews and patient records, and blood samples were drawn for serology. 

Repeat biopsy was more rare in subjects diagnosed in private care or by screening
Alimentary Pharmacology & Therapeutics
The researchers assessed current symptoms and well-being by validated PGWB, SF-36 and GSRS questionnaires.

Malabsorption was more common among those with a repeat biopsy than those without repeat biopsy, as were severe symptoms at diagnosis, and concomitant gastrointestinal or musculoskeletal diseases such as arthritis, osteoporosis and back pain. 

The researchers noted that repeat biopsy was more rare in subjects diagnosed in private care or by screening. 

The team observed that these groups were comparable as to current symptoms and dietary adherence, but those without re-biopsy were less confident of their diet, and more often seropositive on diet. 

They reported better SF-36 physical functioning, and less pain and indigestion, and total GSRS score. 

The research team found that incomplete mucosal recovery was predicted by more advanced histological and serological disease at diagnosis, whereas the groups did not differ in long-term adherence, symptoms, seropositivity, questionnaire scores, frequency of fractures or malignancies.

Dr Kurppa's team concludes, "Severe disease at diagnosis predicted the record of a repeat biopsy and incomplete mucosal recovery."

"Neither lacking biopsy nor incomplete recovery in a relative short time span of 1 year was associated with poorer long-term outcome, although survival bias cannot be excluded."

Aliment Pharmacol Ther 2017: 45(11): 1459–1468 
15 May 2017

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