Prevalence of Primary Sclerosing Cholangitis in Patients With Inflammatory Bowel Disease

Primary sclerosing cholangitis (PSC). This chronic cholestatic liver disease is characterised by an inflammation and fibrosis of the biliary tracts.
Investigators assessed how certain factors influence the prevalence of primary sclerosing cholangitis in patients with inflammatory bowel disease.

The prevalence of primary sclerosing cholangitis (PSC) in patients with inflammatory bowel disease (IBD) may be dependent on type of IBD, sex, and geographical location, according to a systematic review and meta-analysis published in Gastroenterology.

Investigators searched EMBASE, EMBASE Classic, and MEDLINE for studies that enrolled at least 50 participants diagnosed with IBD that also reported the prevalence of PSC. In total, 64 studies were identified which included 776,700 patients from 30 different countries. Results were pooled to determine PSC prevalence in patients diagnosed with IBD.

While overall pooled prevalence was 2.16% (95% CI, 1.76%-2.60%; I2 = 99.1%; P <.0001) for patients with IBD, results indicated this varies by type of IBD. Prevalence was 2.47% in patients with ulcerative colitis, 0.96% in patients with Crohn disease, and 5.01% in patients with IBD-undetermined. PSC was also more likely to be found in men, independent of IBD form.

PSC prevalence differed by geographical region, suggesting that development may be affected by diet, genetic, and/or ethnic influences. The highest prevalence was noted in South America (3.83%), while Southeast Asia was the lowest (0.60%).

The meta-analysis was limited by differences in diagnostic methods and under-representation of certain geographical regions. Additionally, significant heterogeneity was noted among the studies.

Despite these limitations and the need for additional research, understanding the prevalence of PSC in patients diagnosed with IBD can aid clinicians in early detection.


Barberio B, Massimi D, Cazzagon N, Zingone F, Ford AC, Savarino EV. Prevalence of primary sclerosing cholangitis in patients with inflammatory bowel disease: a systematic review and meta-analysis. Gastroenterol. Published online August 20, 2021. doi: 10.1053/j.gastro.2021.08.032