Lower prevalence of Primary sclerosing cholangitis among patients with IBD in Asia: Insights from a multinational study
Primary sclerosing cholangitis (PSC) is a chronic, progressive inflammatory disease characterized by fibrosis and bile duct stricturing, which ultimately leads to cirrhosis and liver failure. PSC is strongly associated with both types of inflammatory bowel disease (IBD), namely, ulcerative colitis and Crohn's disease. However, the patient population in Asia is relatively small, and no large-scale studies have previously examined the prevalence and clinical course of PSC in this region. To address this gap, the research team conducted a multinational collaborative study across six Asian countries.
In this study, 25 institutions from Japan, Korea, China (including Hong Kong), Taiwan, Malaysia, and India analyzed data from approximately 51,000 patients with IBD. The analysis revealed that the prevalence of PSC among patients with IBD in Asian centers is markedly lower than in Western countries, with a tendency toward more favorable clinical outcomes. Furthermore, patients presenting with symptoms such as jaundice or hypoalbuminemia-indicative of impaired liver function—at the time of PSC diagnosis required liver transplantation sooner. However, the proportion of "asymptomatic PSC" at diagnosis has increased in recent years. These patients demonstrated preserved liver function, remaining stable for a prolonged time without needing a liver transplantation. This trend may be attributable to the widespread use of magnetic resonance cholangiopancreatography, a noninvasive imaging modality that enables early-stage detection of PSC.
This study is the first systematic effort in identifying PSC cases among patients with IBD in Asia. The findings are expected to guide the development of clinical practice guidelines tailored to the unique characteristics and healthcare systems of Asian countries.
Reference:
Shintaro Akiyama, Sang Hyoung Park, Ji Eun Baek, Sachiko Kanai, Naminatsu, Prevalence and Outcomes of Primary Sclerosing Cholangitis in Inflammatory Bowel Disease: A Multinational Study across Asia, Clinical Gastroenterology and Hepatology, DOI: https://doi.org/10.1016/j.cgh.2025.11.020
