Prevalence of inflammatory bowel disease in patients with primary sclerosing cholangitis: A systematic review and meta‐analysis

Zhang, Yujie; Gao, Xinbao; He, Zishu; Jia, Hui; Chen, Min; Wang, Xuan; Hong, Liu; Cui, Yuanyuan; Wan, Jian

doi:10.1111/liv.15339

Cited by 9 publications

(7 citation statements)

References 43 publications

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“…1.736-4.295) of CRC and a 36-fold higher risk (adjusted HR, 2.779; and 95% CI, 1.736-4.295) of biliary tract cancer than did UC-alone, which is consistent with the results of various population-based studies and meta-analyses [6,35,59]. Since its initial description by Broome et al[60], the increased risk of CRC in patients with UC-PSC has been rmly established, but the magnitude of and mechanism of action for this potential risk factor remain unclear.…”

supporting

confidence: 86%

Incidence and Adverse Clinical Events of Primary Sclerosing Cholangitis with Ulcerative Colitis

Han

Baek

Hong

et al. 2023

Preprint

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Purpose The aim of this study was to conduct a nationwide population-based study to estimate the incidence of primary sclerosing cholangitis in patients with ulcerative colitis (UC-PSC) and investigate healthcare use, medication use, surgery, cancer, and death as adverse clinical events of UC-PSC.Methods We identified incident cases of UC with (UC-PSC) or without PSC (UC-alone) between 2008 and 2018 using health insurance claims data in Korea. Univariate (crude hazard ratio [HR]) and multivariate analyses were performed to compare the risk of adverse clinical events between groups.Results Overall, 3.38% (487/14,406) patients developed UC-PSC. During a mean follow-up duration of approximately 5.92 years, the incidence of PSC in patients with UC was 185 per 100,000 person-years. The UC-PSC group showed statistically more frequent healthcare use (hospitalization and emergency department visits: HRs, 5.986 and 9.302, respectively; P < .001), higher immunomodulator and biologic use (azathioprine, infliximab, and adalimumab: HRs, 2.061, 3.457, and 3.170, respectively; P < .001), and higher surgery rate (resection of small bowel, operation for intestinal obstruction, and colectomy: HRs, 7.110, 9.728, and 2.940, respectively; P < .001) than did the UC-alone group. The UC-PSC group also showed significantly higher colorectal cancer and biliary tract cancer (HRs, 2.799 and 36.343, respectively; P < .001) and mortality (HR, 4.257) rates than did the UC-alone group.Conclusion Patients with UC-PSC have higher risks of colorectal cancer, biliary tract cancer, and death than do patients with UC-alone. Although considered a rare disease, managing this complex and costly disease requires recognition of the impact of increased burden on health care services.

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confidence: 86%

Incidence and Adverse Clinical Events of Primary Sclerosing Cholangitis with Ulcerative Colitis

Han

Baek

Hong

et al. 2023

Preprint

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“…For another, gut microbiota can also affect PSC by evoking dysregulated immune responses. As a disease partly resulting from gut dysbiosis, inflammatory bowel disease (IBD) has been reported to be closely associated with the etiology of PSC, and about 70% of PSC patients also have IBD [23]. For instance, family Ruminococcaceae has been found to be transiently and dramatically enriched in response to increased IBD activity and is considered as a risk factor for IBD [24,25].…”

Section: Discussionmentioning

confidence: 99%

A bidirectional two-sample Mendelian randomization using the gut microbiota to reveal potential therapeutic targets for primary sclerosing cholangitis

Liang,

Wang,

Shu

et al. 2023

European Journal of Gastroenterology &Amp; Hepatology

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Background Previous studies indicate that gut microbiota correlates to primary sclerosing cholangitis (PSC), but the causation is still unclear. We sought to reveal the causal relationship between gut microbiota and PSC with a bidirectional two-sample Mendelian randomization (MR) analysis. Methods The large-scale genome-wide association study (GWAS) summary statistics and a bidirectional two-sample MR study were used to assess the causality between gut microbiota and PSC. Multiple sensitivity analyses were used to identify the robustness of our results. Results Three microbial taxa causally correlated to PSC. Genus Ruminococcaceae UCG002 (OR: 1.855, 95% CI: 1.068–3.220, P = 0.028) increased the risk of PSC. Class Betaproteobacteria (OR: 0.360, 95% CI: 0.171–0.758, P = 0.007), and genus Ruminiclostridium6 (OR: 0.474, 95% CI: 0.219–0.820, P = 0.011) had protective effects on PSC. In addition, we found the causal relationship of PSC with higher abundance of genus Dialister (beta: 0.059, 95% CI: 0.017–0.102, P = 0.006), genus Veillonella (beta: 0.065, 95% CI: 0.016–0.113, P = 0.009), class Melainabacteria (beta: 0.073, 95% CI: 0.012–0.133, P = 0.019), and order Gastranaerophilales (beta: 0.072, 95% CI: 0.011–0.113, P = 0.133). Conclusion Our study reveals the causality between gut microbiota and PSC, providing new insights into the pathological mechanisms of PSC and facilitating the development of novel biomarkers and disease-modifying therapeutics for PSC from the perspective of gut microbiota.

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“…The prevalence was higher in men with IBD (2.09%) compared with women (1.79%), p < 0.001. Overall, the highest pooled prevalence was observed in South America and the lowest in South East Asia [84].…”

Section: Primary Sclerosing Cholangitismentioning

confidence: 91%

Are Gender Differences Important for Autoimmune Liver Diseases?

Floreani,

Gabbia,

De Martin

2024

Life

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Gender Medicine has had an enormous expansion over the last ten years. Autoimmune liver diseases include several conditions, i.e., autoimmune hepatitis (AIH), primary biliary cholangitis (PBC), primary sclerosing cholangitis (PSC), and conditions involving the liver or biliary tree overlapping with AIH, as well as IgG4-related disease. However, little is known about the impact of sex in the pathogenesis and natural history of these conditions. The purpose of this review is to provide an update of the gender disparities among the autoimmune liver diseases by reviewing the data published from 1999 to 2023. The epidemiology of these diseases has been changing over the last years, due to the amelioration of knowledge in their diagnosis, pathogenesis, and treatment. The clinical data collected so far support the existence of sex differences in the natural history of autoimmune liver diseases. Notably, their history could be longer than that which is now known, with problems being initiated even at a pediatric age. Moreover, gender disparity has been observed during the onset of complications related to end-stage liver disease, including cancer incidence. However, there is still an important debate among researchers about the impact of sex and the pathogenesis of these conditions. With this review, we would like to emphasize the urgency of basic science and clinical research to increase our understanding of the sex differences in autoimmune liver diseases.

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Prevalence of inflammatory bowel disease in patients with primary sclerosing cholangitis: A systematic review and meta‐analysis

Cited by 9 publications

References 43 publications

Incidence and Adverse Clinical Events of Primary Sclerosing Cholangitis with Ulcerative Colitis

Incidence and Adverse Clinical Events of Primary Sclerosing Cholangitis with Ulcerative Colitis

A bidirectional two-sample Mendelian randomization using the gut microbiota to reveal potential therapeutic targets for primary sclerosing cholangitis

Are Gender Differences Important for Autoimmune Liver Diseases?

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