Department of Gastroenterology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan.
Department of Internal Medicine, Division of Gastroenterology, Hepatology and Motility, University of Kansas, Lawrence, Kansas, USA.
J Gastroenterol Hepatol. 2022 Aug;37(8):1474-1484. doi: 10.1111/jgh.15894. Epub 2022 Jun 2.
Autoimmune pancreatitis (AIP) and inflammatory bowel disease (IBD) are categorized into immune-mediated inflammatory disorders (IMIDs). While AIP is a pancreato-biliary IMID with an increased incidence and prevalence among patients with IBD, its features are still unclear. This systematic review and meta-analysis aims to assess the prevalence and clinical characteristics of AIP-IBD patients.
Electronic databases were searched to identify observational studies assessing AIP and IBD. The primary outcome was the prevalence of IBD among AIP patients, and vice versa. Secondary outcomes included clinical findings and outcomes of each IMID in AIP-IBD patients. The pooled rate of each outcome was determined using a random effects model.
For primary outcomes, 40 observational studies with 4031 AIP patients were included and the pooled prevalence of IBD was 10.5% (95% CI 7.2-15.0%). Meanwhile, five studies with 10,551 IBD patients were included and the pooled prevalence of AIP was 0.6% (95% CI 0.2-1.9%). For secondary outcomes, 53 observational studies with 469 AIP-IBD patients were assessed. The rates of type 2 AIP and ulcerative colitis were 79.2% (95% CI 69.1-86.6%) and 74.8% (95% CI 68.2-80.4%), respectively. We also demonstrated AIP-IBD patients were at a significant increased risk of AIP recurrence and colectomy compared with patients with either AIP or IBD (RR = 1.9, 95% CI 1.1-3.1 and P = 0.014 and RR = 3.7, 95% CI 1.9-6.9, P < 0.001, respectively).
Our meta-analysis reported the prevalence of AIP-IBD patients and demonstrated patients with both IMIDs had a high risk of poor outcomes.
自身免疫性胰腺炎（AIP）和炎症性肠病（IBD）被归类为免疫介导的炎症性疾病（IMIDs）。虽然 AIP 是一种胰胆管 IMID，在 IBD 患者中的发病率和患病率较高，但它的特征仍不清楚。本系统评价和荟萃分析旨在评估 AIP-IBD 患者的患病率和临床特征。
电子数据库检索评估 AIP 和 IBD 的观察性研究。主要结局是 AIP 患者中 IBD 的患病率，反之亦然。次要结局包括 AIP-IBD 患者中每种 IMID 的临床发现和结局。使用随机效应模型确定每个结局的汇总率。
对于主要结局，纳入了 40 项观察性研究，共纳入了 4031 例 AIP 患者，IBD 的总体患病率为 10.5%（95%CI7.2-15.0%）。同时，纳入了 5 项研究，共纳入了 10551 例 IBD 患者，AIP 的总体患病率为 0.6%（95%CI0.2-1.9%）。对于次要结局，评估了 53 项观察性研究，共纳入了 469 例 AIP-IBD 患者。2 型 AIP 和溃疡性结肠炎的发生率分别为 79.2%（95%CI69.1-86.6%）和 74.8%（95%CI68.2-80.4%）。我们还表明，与单独患有 AIP 或 IBD 的患者相比，AIP-IBD 患者 AIP 复发和结肠切除术的风险显著增加（RR=1.9，95%CI1.1-3.1，P=0.014 和 RR=3.7，95%CI1.9-6.9，P<0.001）。
我们的荟萃分析报告了 AIP-IBD 患者的患病率，并表明同时患有两种 IMIDs 的患者预后不良的风险较高。
