Journal of the Canadian Association of Gastroenterology · 2025
Infections in primary sclerosing cholangitis and inflammatory bowel disease: a systematic review and meta-analysis.
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Natt Navneet, Jones May Tyrel, Malhi Gurpreet, Dumond Jennifer, Gulamhusein Aliya, Tandon Parul
Аннотация
PURPOSE: Primary sclerosing cholangitis (PSC) is a cholestatic liver disease that frequently coexists with inflammatory bowel disease (IBD). The risk of infections in patients with concurrent PSC-IBD remains unclear. The aim of this study was to identify the event rate of infections and associated risk factors in PSC-IBD patients.
METHODS: MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials were searched from inception to September 12, 2024 for studies examining event rate or risk factors for infection in patients with PSC-IBD. The primary outcome was the event rate of all-cause and site-specific infections as well as infection-related mortality. The secondary outcome was risk factors for infection. Random-effects models were used to calculate pooled odds ratios (OR) with 95% confidence intervals (CI) comparing the event rate of all-cause infections in PSC-IBD patients to those with just PSC and just IBD. I 2 values more than 50% suggested substantial heterogeneity.
RESULTS: Eighty-one studies were included. The pooled event rate of all-cause infections in patients with PSC-IBD was 25.1% (95% CI, 17.0%-33.2%, I 2 = 99.2%). PSC-IBD patients had significantly increased odds of all-cause infection (OR 3.67, 95% CI, 2.07-6.52, I 2 = 41.9%), sepsis (OR 3.35, 95% CI, 2.29-4.91, I 2 = 9.1%), and infection-related mortality (OR 11.25, 95% CI, 2.03-62.37, I 2 = 0) compared to those with IBD but not those with PSC.
CONCLUSION: Patients with PSC-IBD appear to be at increased risk of all-cause infection, sepsis, and mortality compared to those with IBD alone.
METHODS: MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials were searched from inception to September 12, 2024 for studies examining event rate or risk factors for infection in patients with PSC-IBD. The primary outcome was the event rate of all-cause and site-specific infections as well as infection-related mortality. The secondary outcome was risk factors for infection. Random-effects models were used to calculate pooled odds ratios (OR) with 95% confidence intervals (CI) comparing the event rate of all-cause infections in PSC-IBD patients to those with just PSC and just IBD. I 2 values more than 50% suggested substantial heterogeneity.
RESULTS: Eighty-one studies were included. The pooled event rate of all-cause infections in patients with PSC-IBD was 25.1% (95% CI, 17.0%-33.2%, I 2 = 99.2%). PSC-IBD patients had significantly increased odds of all-cause infection (OR 3.67, 95% CI, 2.07-6.52, I 2 = 41.9%), sepsis (OR 3.35, 95% CI, 2.29-4.91, I 2 = 9.1%), and infection-related mortality (OR 11.25, 95% CI, 2.03-62.37, I 2 = 0) compared to those with IBD but not those with PSC.
CONCLUSION: Patients with PSC-IBD appear to be at increased risk of all-cause infection, sepsis, and mortality compared to those with IBD alone.