Prevalence and Outcomes of Primary Sclerosing Cholangitis in Inflammatory Bowel Disease: A Multinational Study Across Asia

作者：Shintaro Akiyama, Sang Hyoung Park, Ji Eun Baek, Sachiko Kanai, Naminatsu Takahara, Ryosuke Kasuga, Nobuhiro Nakamoto, Yasuhiro Takagi, Shinichiro Shinzaki, Meng‐Tzu Weng, Shu‐Chen Wei, Toshio Fujisawa, Hiroyuki Isayama, Sidharth Harindranath, Devendra Desai, Jie Liang, Daye Park, Soo Jung Park, Suguru Mizuno, Satoshi Mochida, Karen Hei-Tung Lai, Joyce Wing Yan Mak, Xin Hui Khoo, Ida Hilmi, Naoki Ishikawa, Yu Bei Gu, Hu Zhang, Shin Ju Oh, Yasuki Sano, Yusuke Honzawa, Tsz-Fai Cheng, Katsuyoshi Matsuoka, Dong‐Hyun Kim, Takeshi Fujima, Minoru Matsuura, Kyeong Ok Kim, Byung Ik Jang, Hsu‐Heng Yen, Sung-Ae Jung, To-Lam Suen, Yen‐Hsuan Ni, Makoto Naganuma · 发表于：Clinical Gastroenterology and Hepatology · 年份：2025 · DOI：10.1016/j.cgh.2025.11.020 · 被引用次数：4 · 研究领域：Liver Diseases and Immunity、Gallbladder and Bile Duct Disorders、Inflammatory Bowel Disease

BACKGROUND & AIMS: Primary sclerosing cholangitis (PSC) frequently coexists with inflammatory bowel disease (IBD). PSC is a progressive disease that may lead to end-stage liver failure requiring liver transplantation (LT). Although PSC-IBD has been extensively studied in Western populations, data from Asia remain limited. We conducted an international multicenter study across Asia to investigate the prevalence of PSC in IBD patients and evaluate its impact on clinical outcomes. METHODS: This retrospective cohort study included patients with IBD from 25 hospitals in 6 Asian countries. The primary endpoint was the prevalence of PSC in patients with IBD. The secondary endpoints included the incidence of colorectal neoplasia and IBD-related surgery following IBD diagnosis, and the occurrence of cholangiocarcinoma, LT, and death after PSC diagnosis among patients with PSC-IBD. Temporal trends were assessed across 5 diagnostic eras of PSC. RESULTS: Among 51,314 patients with IBD, 474 had PSC (0.92%), with a prevalence of 1.4% in ulcerative colitis and 0.13% in Crohn's disease. Among 375 Asian patients with PSC-IBD, 9.1% developed colorectal neoplasia, 7.2% developed cholangiocarcinoma, 24% underwent LT, and 16% died. In more recent diagnostic eras, patients presented with fewer symptoms, lower alkaline phosphatase levels, and better liver function scores. The use of magnetic resonance cholangiopancreatography has increased over time. Symptomatic PSC and low serum albumin were signi...