Bálint Tél, MD 1, Bence Stubnya 1, Noémi Gede, MSc 2, Péter Hegyi, MD, Ph.D., DSc 2, Zoltán Kiss, MSc 1, Gábor Veres, MD, Ph.D., DSc 1,2
1 1st Department of Paediatrics, Semmelweis University, Budapest, Hungary
2 Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
Introduction: Patients with inflammatory bowel disease (IBD) are posed to a higher chance of developing acute pancreatitis (AP). This elevated probability of pancreatitis may be a result of an extraintestinal manifestation of IBD, as well as of medication side effects. The extent of this elevated chance for pancreatitis is, however, not well established.
Aims: To perform an evidence synthesis on the risk of acute pancreatitis in IBD
Methods: Systematic search of PubMed/MEDLINE, EMBASE, SCOPUS, Web of Science and Cochrane Library from inception to 30th October 2017. Observational studies and randomized trials (RCT), reporting the occurrence of AP in an IBD population of any age, were included. Filters for “English” and “human” were applied. All stages of screening and data extraction were conducted independently by two reviewers. Data extracted included study characteristics, population, the rate of AP and outcomes. When feasible, pooled analyses were performed using random effects model.
Results: After screening 2679 entries of the database search, a total of 205 studies were included in this meta-analysis. Six of the 205 publication were case-control studies (including 120 393 patients), assessing the proportion of comorbid IBD within the group of patients with their first AP episode. The other 199 studies reported the events of AP among IBD patients. Acute pancreatitis was associated with an increased chance for comorbid IBD (OR = 2.13 [CI: 1.96-2.32], p<0.00001). Also, an AP episode was seen in approximately in 1% of the IBD population. (event rate: 1,26 [CI: 1.01-1.52%; p<0.00001]). Subgroup analysis of the studies is currently in progress.
Conclusion: Our meta-analysis showed, that approximately every 1 in 100 IBD patients will develop AP. The etiology, clinical behavior and prognosis of AP in IBD is, however, not well explored. Therefore a prospective, multicentre observational study is needed to characterize AP in patients with IBD.
Doctoral School of Clinical Medicine
Prevention of Chronic Diseases in Childhood Program
Supervisor: Gábor Veres