{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T22:24:18Z","timestamp":1789424658118,"version":"build-2803163510"},"reference-count":53,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2024,1,11]],"date-time":"2024-01-11T00:00:00Z","timestamp":1704931200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Data on mortality in coeliac disease are contrasting.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To systematically review the literature on all\u2010cause and cause\u2010specific mortality in coeliac disease compared to the general population, and evaluate differences across clinical phenotypes, geographical regions, and over time.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We searched PubMed and Embase from 1 January 1970 to 31 December 2022 for eligible studies reporting on all\u2010cause and cause\u2010specific mortality in coeliac disease compared to the general population or controls. The protocol was registered on Open Science Framework (<jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"https:\/\/doi.org\/10.17605\/OSF.IO\/852DN\">https:\/\/doi.org\/10.17605\/OSF.IO\/852DN<\/jats:ext-link>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We included 25 studies. All\u2010cause mortality (HR 1.16, 95% CI 1.05\u20131.27, <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u200989%), mortality due to malignancies (HR 1.21, 95% CI 1.08\u20131.36, <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u200965%) and respiratory disease (HR 1.39, 95% CI 1.04\u20131.86, <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u200976%) were increased. Mortality due to non\u2010Hodgkin lymphoma (HR 10.14, 95% CI 2.19\u201346.88, <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u200996%) was markedly increased. Mortality significantly decreased in recent decades: 1989\u20132004 (HR 1.61, 95% CI 1.27\u20132.03, <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u200991%), 2005\u20132014 (HR 1.16, 95% CI 0.99\u20131.36, <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u200989%), 2015\u20132022 (HR 1.19, 95% CI 1.05\u20131.35, <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u200993%). All\u2010cause mortality was not increased in dermatitis herpetiformis (HR 0.85, 95% CI 0.73\u20130.99, <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u200940%) and undiagnosed coeliac disease (HR 1.09, 95% CI 0.95\u20131.25, <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u20090%). Mortality was increased in the UK (HR 1.23, 95% CI 1.03\u20131.47, <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u200991%) but not Scandinavia (HR 1.01, 95% CI 0.91\u20131.13, <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u200981%). Limitations include high heterogeneity and lack of data for many countries.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Mortality in coeliac disease is increased, predominantly due to malignancies\u2014particularly non\u2010Hodgkin lymphoma\u2014although differing significantly across disease phenotypes. Mortality of patients with coeliac disease has significantly decreased in recent decades. These results may influence diagnosis and management.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.17867","type":"journal-article","created":{"date-parts":[[2024,1,11]],"date-time":"2024-01-11T08:26:15Z","timestamp":1704961575000},"page":"592-605","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Systematic review with meta\u2010analysis: Cause\u2010specific and all\u2010cause mortality trends across different coeliac disease phenotypes"],"prefix":"10.1111","volume":"59","author":[{"given":"Stiliano","family":"Maimaris","sequence":"first","affiliation":[{"name":"Department of Internal Medicine and Therapeutics University of Pavia  Pavia Italy"},{"name":"Gastroenterology Unit of Pavia Institute, Istituti Clinici Scientifici Maugeri IRCCS  Pavia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8493-7698","authenticated-orcid":false,"given":"Annalisa","family":"Schiepatti","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Therapeutics University of Pavia  Pavia Italy"},{"name":"Gastroenterology Unit of Pavia Institute, Istituti Clinici Scientifici Maugeri IRCCS  Pavia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2227-4622","authenticated-orcid":false,"given":"Federico","family":"Biagi","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Therapeutics University of Pavia  Pavia Italy"},{"name":"Gastroenterology Unit of Pavia Institute, Istituti Clinici Scientifici Maugeri IRCCS  Pavia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,1,11]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2013-306578"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2011-301346"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.2.5654.401"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(76)92843-9"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.3109\/00365528509089626"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-230X-14-139"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dld.2017.12.001"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dld.2013.10.010"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.16599"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(01)05554-4"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.163.13.1566"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1023\/A:1026655609906"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/0016-5085(89)90060-7"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.14309\/ajg.0000000000000665"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2014-308285"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.1943"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2011.04972.x"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.2012.11105.x"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2010.05.041"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dld.2015.06.004"},{"key":"e_1_2_8_23_1","volume-title":"In Cochrane handbook for systematic reviews of interventions version 6.4 (updated august 2023)","author":"Page MJ","year":"2023"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2010.506"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2009.1320"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2007.01111.x"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dld.2006.03.002"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dld.2022.04.016"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.16206"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.14309\/ajg.0000000000000737"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1177\/2050640618814662"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgast-2018-000201"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2011.04811.x"},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.1080\/07853890903036199"},{"key":"e_1_2_8_35_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2008.03660.x"},{"key":"e_1_2_8_36_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v13.i1.146"},{"key":"e_1_2_8_37_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2004.02008.x"},{"key":"e_1_2_8_38_1","doi-asserted-by":"publisher","DOI":"10.1093\/qjmed\/91.12.853"},{"key":"e_1_2_8_39_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.1993.tb03516.x"},{"key":"e_1_2_8_40_1","doi-asserted-by":"publisher","DOI":"10.1038\/nm0797-797"},{"key":"e_1_2_8_41_1","doi-asserted-by":"publisher","DOI":"10.14309\/ajg.0000000000000523"},{"key":"e_1_2_8_42_1","first-page":"15","article-title":"Directive 2003\/89\/EC of the European Parliament and of the council of 10 November 2003","volume":"308","year":"2003","journal-title":"Off J European Union"},{"key":"e_1_2_8_43_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.13867"},{"key":"e_1_2_8_44_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.52.7.960"},{"key":"e_1_2_8_45_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kws397"},{"key":"e_1_2_8_46_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dld.2015.11.016"},{"key":"e_1_2_8_47_1","doi-asserted-by":"publisher","DOI":"10.1097\/MCG.0000000000000533"},{"key":"e_1_2_8_48_1","doi-asserted-by":"publisher","DOI":"10.1177\/2050640618786790"},{"key":"e_1_2_8_49_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.40.2.289"},{"key":"e_1_2_8_50_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.43.5.728-g"},{"key":"e_1_2_8_51_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.numecd.2015.05.004"},{"key":"e_1_2_8_52_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2017.06.037"},{"key":"e_1_2_8_53_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2023-329751"},{"key":"e_1_2_8_54_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2010.10"}],"container-title":["Alimentary Pharmacology &amp; Therapeutics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/apt.17867","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,3,20]],"date-time":"2024-03-20T07:59:55Z","timestamp":1710921595000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/apt.17867"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1,11]]},"references-count":53,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2024,3]]}},"alternative-id":["10.1111\/apt.17867"],"URL":"https:\/\/doi.org\/10.1111\/apt.17867","archive":["Portico"],"relation":{},"ISSN":["0269-2813","1365-2036"],"issn-type":[{"value":"0269-2813","type":"print"},{"value":"1365-2036","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1,11]]},"assertion":[{"value":"2023-07-22","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-12-22","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-01-11","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}