Association of Psoriasis With Inflammatory Bowel Disease

Abstract

IMPORTANCE Patients with psoriasis may experience comorbidities involving cardiovascular diseases, chronic kidney disease, uveitis, psychiatric disturbances, and metabolic syndrome. However, the association between psoriasis and inflammatory bowel disease (IBD) has been largely unclear. OBJECTIVE To investigate the association of psoriasis with IBD. DATA SOURCES For this systematic review and meta-analysis, MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials were searched for relevant studies from inception to January 17, 2018. STUDY SELECTION Case-control, cross-sectional, or cohort studies that examined either the odds or risk of IBD in patients with psoriasis were included. No geographic or language limitations were used in the search. DATA EXTRACTION AND SYNTHESIS The PRISMA and MOOSE guidelines were followed for data extraction. The Newcastle-Ottawa Scale was used to evaluate the risk of bias of included studies. Crohn disease and ulcerative colitis were analyzed separately and random-effects model meta-analysis was conducted. A subgroup analysis was performed on psoriatic arthritis. MAIN OUTCOMES AND MEASURES The risk and odds of IBD, Crohn disease, and ulcerative colitis in patients with psoriasis. RESULTS A total of 5 case-control or cross-sectional studies and 4 cohort studies with 7 794 087 study participants were included. Significant associations were found between psoriasis and Crohn disease (odds ratio, 1.70; 95% CI, 1.20-2.40) and between psoriasis and ulcerative colitis (odds ratio, 1.75; 95% CI, 1.49-2.05). Patients with psoriasis had an increased risk of Crohn disease (risk ratio, 2.53; 95% CI, 1.65-3.89) and ulcerative colitis (risk ratio, 1.71; 95% CI, 1.55-1.89). CONCLUSIONS AND RELEVANCE These findings suggest that psoriasis is significantly associated with IBD. Gastroenterology consultation may be indicated when patients with psoriasis present with bowel symptoms.

Prevalence of inflammatory bowel disease in Japanese psoriatic patients

“…Another Korean study using the claims database also showed increased prevalence of IBD in the psoriatic population . A meta‐analysis reviewing all ethnic groups also showed a 2.53‐fold increased risk of developing Crohn's disease and a 1.71‐fold increased risk of developing UC …”

“…Another Korean study using the claims database also showed increased prevalence of IBD in the psoriatic population. 15 A meta-analysis reviewing all ethnic groups also showed 16 There has been little epidemiological research in the Japanese population. Using a claims database, Terui et al 17 reported that among 2824 patients with psoriasis, CD and UC were present in four (0.14%) and 18 (0.64%), respectively.…”

The Risk of Systemic Diseases in Those with Psoriasis and Psoriatic Arthritis: From Mechanisms to Clinic

“…As patients with PsA have relatively higher levels of systemic inflammation than patients with psoriasis only [ 109 ], this could be a possible explanation for this association. With regards to IBD, a meta-analysis confirmed the increased odds of IBD in patients with PsA [ 116 ]. Although there are some conflicting results regarding the association between autoimmune thyroiditis and psoriasis, the relevant association between autoimmune thyroiditis and PsA has been consistently found in various studies.…”

Metformin May Block the Way Breast Cancer Metastasis: A Meta-analysis and Mechanism Review

“…Our work was performed according to the Preferred Reporting Items for Systematic Review ang Meta-Analysis Protocols (PRISMA-P) 2015 statement. The quality of retrospective cohort studies we intended to include was assessed with reference to the NOS, which was composed of three parts: selection, comparability and exposure, and only the study score was not less than 6 stars (up to 9 stars) could be accepted [18,19]. The rest of studies were RCTs, thus we chose Chcorane Risk of Bias tool to assess their quality.…”