Multiple sclerosis and inflammatory bowel disease: A systematic review and meta-analysis.
Level 3 - non-randomized controlled study
Systematic review and meta-analysis of observational studies
PubMed 35092169 · doi:10.1002/acn3.51495
What was done
A systematic review and meta-analysis of PubMed, Web of Science, and Embase databases through November 2020 evaluating the co-occurrence of multiple sclerosis (MS) and inflammatory bowel disease (IBD). Across 17 included studies, investigators calculated pooled prevalence estimates and pooled risk ratios (RR) measuring the risk of IBD (including Crohn's disease [CD] and ulcerative colitis [UC]) in MS patients, and MS in IBD patients, relative to control populations.
What was found
The pooled prevalence of MS in patients with IBD was 0.2% (95% CI 0.1–0.4%), and the prevalence of IBD in patients with MS was 0.6% (95% CI 0.4–0.9%). Compared to controls, patients with MS had a significantly higher prevalence of IBD (RR = 1.53, 95% CI 1.38–1.70, p < 0.00001), with comparable risk for CD (RR = 1.41, 95% CI 1.14–1.74, p = 0.001) and UC (RR = 1.42, 95% CI 1.17–1.71, p = 0.0003; p for subgroup difference = 0.97). Patients with IBD also had an increased prevalence of MS compared to controls (RR = 1.91, 95% CI 1.06–3.45, p = 0.03).
Why it matters
This study quantifies a modest but statistically significant bidirectional association between MS and both major subtypes of IBD, supporting clinical surveillance for comorbid autoimmune manifestations across both conditions.
Limits
The total number of individual participants is not reported in the abstract. As a meta-analysis of observational data, residual confounding, varying diagnostic criteria, and temporal ordering of diagnoses across primary studies cannot be evaluated from the abstract. Heterogeneity metrics and publication bias assessments are not provided in the summary text.
Cited by
- supports Inflammatory bowel disease is strongly linked to an increased risk of developing multiple sclerosis.