TOPLINE:
The association of primary sclerosing cholangitis (PSC) with paediatric-onset inflammatory bowel disease (IBD) affected the disease prognosis, with nearly a 28-fold higher risk for cancer and a 13-fold higher risk for mortality seen among patients with IBD and PSC than among the general population.
METHODOLOGY:
- Researchers assessed the impact of concomitant PSC on the prognosis of paediatric-onset IBD in a retrospective study analysing children diagnosed with IBD before 17 years of age and radiologically and/or histologically proven PSC from a population‐based IBD registry in northern France (between 1988 and 2019).
- They included 24 patients with IBD and PSC and 96 propensity score-matched control patients with IBD (for both groups: median age at the diagnosis of IBD, 13 years; 58% boys).
- Mortality, cancer occurrence, intestinal resection, and treatment exposure were assessed among patients with IBD with and without PSC, with a median follow-up duration of 7 years for the IBD-PSC group and 6.3 years for the matched IBD group.
TAKEAWAY:
- Patients in the IBD-PSC group showed a 13.3-fold higher risk for mortality than the general population (standardised mortality ratio, 13.3; P = .010).
- Moreover, they had a 27.9-fold higher risk for cancer than the general population (standardised incidence ratio, 27.9; P = .002).
- No significant difference in cumulative surgery rates at 5 years was found between IBD-PSC and matched IBD groups.
- At 1 and 5 years, cumulative probabilities regarding the use of immunosuppressants, corticosteroids, or anti-TNF therapy were not significantly different between IBD-PSC and matched IBD groups.
IN PRACTICE:
“Close follow‐up to ensure early detection of both colonic and hepatic cancers seems necessary, particularly during adolescence and the transition to adulthood,” the authors of the study wrote.
SOURCE:
This study was led by Marie‐Laura Godet, Department of Pediatrics, CHU Lille, Lille, France. It was published online on August 12, 2025, in the Journal of Pediatric Gastroenterology and Nutrition.
LIMITATIONS:
The sample size of the cohort was relatively small, thereby affecting the analysis of treatment exposure owing to a lack of statistical power.
DISCLOSURES:
This study was supported by the François Aupetit Association, Programme Hospitalier de Recherche Clinique interrégional, and the Conseil Régional du Nord‐Pas‐de‐Calais (INSPIRED cohort). The registry involved in the study received financial support from the François Aupetit Association, Lille University Hospital, Amiens University Hospital, and Rouen University Hospital. The authors declared having no conflicts of interest.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.