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Multiple sclerosis and inflammatory bowel diseases: a systematic review and meta-analysis

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Abstract

The association between multiple sclerosis (MS) and inflammatory bowel disease (IBD) has been suggested, apart from their common epidemiological and immunological patterns, also due to observations of increased incidence of both IBD among MS patients and MS among IBD patients. We estimated the risk of concurrent IBD and MS comorbidity, using data from all available case–control studies. We calculated the corresponding Risk ratios (RRs) in each included case–control study to express the risk of IBD and MS concurrence at a given population. We performed additional subgroup analyses according to the type of registry from which the data of the cases were exported (IBD or MS registry) and the IBD type (Crohn’s disease, CD or Ulcerative colitis, UC). We included 10 studies, comprising a total of 1,086,430 patients (0.08% of them with concurrent IBD and MS). Pooled RR for IBD/MS comorbitity was 1.54 (95% CI 1.40–1.67; p < 0.0001) with no differences (p = 0.91) among IBD and MS registries (RR 1.53, 95% CI 1.36–1.72, p < 0.001 for MS comorbidity in IBD patients vs. RR 1.55, 95% CI 1.32–1.81, p < 0.001 for IBD comorbidity in MS patients). No difference was also found on the risk of MS comorbidity among patients with CD or UC (RR 1.52, 95% CI 1.34–1.72, p < 0.001 vs. RR 1.55, 95% CI 1.38–1.74, p < 0.001; p for subgroup differences: 0.84). In all analyses no evidence of heterogeneity or publication bias was detected. Both IBD and MS patients seem to have a fifty-percent increased risk of MS or IBD comorbidity, respectively, with no apparent differences between patients with CD or UC.

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    Authors and Affiliations

    1. First Division of Internal Medicine, School of Medicine, University of Ioannina, Ioannina, Greece

      Maria Kosmidou

    2. Department of Neurology, School of Medicine, University of Ioannina, University Campus, 45110, Ioannina, Greece

      Aristeidis H. Katsanos, Athanassios P. Kyritsis & Sotirios Giannopoulos

    3. HepatoGastroenterology Unit, School of Medicine, University of Ioannina, Ioannina, Greece

      Konstantinos H. Katsanos & Dimitrios Christodoulou

    4. Neurosurgical Research Institute, University of Ioannina, Ioannina, Greece

      Athanassios P. Kyritsis & Sotirios Giannopoulos

    5. Second Department of Neurology, School of Medicine, University of Athens, Athens, Greece

      Georgios Tsivgoulis

    6. Department of Neurology, University of Tennessee Health Science Center, Memphis, USA

      Georgios Tsivgoulis

    Authors
    1. Maria Kosmidou
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    2. Aristeidis H. Katsanos
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    3. Konstantinos H. Katsanos
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    4. Athanassios P. Kyritsis
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    5. Georgios Tsivgoulis
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    6. Dimitrios Christodoulou
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    7. Sotirios Giannopoulos
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    Correspondence to Sotirios Giannopoulos.

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    On behalf of all authors, the corresponding author states that there is no conflict of interest.

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    This article does not contain any studies performed with humans or animals performed by any of the authors.

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    Maria Kosmidou and Aristeidis H. Katsanos contributed equally to the work.

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    Kosmidou, M., Katsanos, A.H., Katsanos, K.H. et al. Multiple sclerosis and inflammatory bowel diseases: a systematic review and meta-analysis. J Neurol 264, 254–259 (2017). https://doi.org/10.1007/s00415-016-8340-8

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    • DOI: https://doi.org/10.1007/s00415-016-8340-8

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