{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T11:45:13Z","timestamp":1792583113060,"version":"4.5.0"},"reference-count":64,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T00:00:00Z","timestamp":1792540800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T00:00:00Z","timestamp":1792540800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health and Care Research","doi-asserted-by":"publisher","award":["NIHR302616"],"award-info":[{"award-number":["NIHR302616"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aliment Pharmacol Ther"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Inflammatory bowel disease (IBD) associated with primary sclerosing cholangitis (PSC) is a distinct phenotype (PSC\u2010IBD). Data on the safety and effectiveness of advanced IBD therapies on IBD outcomes in PSC\u2010IBD remain limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic review and meta\u2010analysis assessed the safety and effectiveness of advanced therapies in adults with PSC\u2010IBD. MEDLINE, Embase, Cochrane databases and Web of Science were searched to July 2026. The primary outcome was IBD clinical remission. Secondary outcomes included clinical response, corticosteroid\u2010free remission, mucosal healing, adverse event\u2010related treatment discontinuation and colorectal neoplasia. A random\u2010effects model was used for pooled estimates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Five retrospective case\u2010series (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009394) evaluating infliximab, adalimumab, vedolizumab and tofacitinib were included (median follow\u2010up of 18.4\u2009months). Pooled clinical remission rates were 24.7% (95% CI: 17.2%\u201333.0%) at 3\u2009months and 28.6% (95% CI: 16.3%\u201342.6%) at 6\u201312\u2009months. Corticosteroid\u2010free remission was achieved in 45.4% (95% CI: 33.1%\u201357.9%) and mucosal healing in 25.6% (95% CI: 13.6%\u201339.5%). Tofacitinib was associated with a clinical response rate of 59.3% (95% CI: 40.0%\u201377.2%) and low adverse event rate, in a single available study. Adverse event\u2010related discontinuation occurred in 9.1% (95% CI: 4.4%\u201315.1%), while 31.8% (95% CI: 25.5%\u201338.5%) experienced primary non\u2010response or secondary loss of response. The pooled proportion of colorectal neoplasia was 10.5% (12\/112; 95% CI: 5.3%\u201317.1%). Five patients developed colorectal cancer (5\/112; 4.3%) and two (2\/177; 0.8%) cholangiocarcinoma.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Advanced IBD therapies demonstrate modest but encouraging effectiveness and an acceptable safety profile in PSC\u2010IBD; however, the available evidence is limited by retrospective study designs, small sample sizes and substantial clinical and methodological heterogeneity. Prospective controlled studies using standardised IBD outcomes are needed to inform optimal therapeutic strategies in this high\u2010risk population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>PROSPERO: CRD42024580296<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/apt.71045","type":"journal-article","created":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T11:12:37Z","timestamp":1792581157000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Meta\u2010Analysis: Safety and Effectiveness of Advanced Therapies in Inflammatory Bowel Disease Patients With Concomitant Primary Sclerosing Cholangitis"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2719-1607","authenticated-orcid":false,"given":"Amera","family":"Elzubeir","sequence":"first","affiliation":[{"name":"Norwich Medical School University of East Anglia  Norwich UK"},{"name":"Department of Gastroenterology Norfolk and Norwich University Hospital NHS Foundation Trust  Norwich UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4239-3511","authenticated-orcid":false,"given":"Anjana","family":"Kumar","sequence":"additional","affiliation":[{"name":"Norwich Medical School University of East Anglia  Norwich UK"},{"name":"Department of General Surgery Norfolk and Norwich University Hospital NHS Foundation Trust  Norwich UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-8571-7363","authenticated-orcid":false,"given":"Alistair","family":"McArdle","sequence":"additional","affiliation":[{"name":"Department of General Surgery Norfolk and Norwich University Hospital NHS Foundation Trust  Norwich UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily","family":"Holden","sequence":"additional","affiliation":[{"name":"Norwich Medical School University of East Anglia  Norwich UK"},{"name":"Department of Gastroenterology Norfolk and Norwich University Hospital NHS Foundation Trust  Norwich UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leo","family":"Alexandre","sequence":"additional","affiliation":[{"name":"Norwich Medical School University of East Anglia  Norwich UK"},{"name":"Department of Gastroenterology Norfolk and Norwich University Hospital NHS Foundation Trust  Norwich UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1088-9742","authenticated-orcid":false,"given":"Simon","family":"Rushbrook","sequence":"additional","affiliation":[{"name":"Norwich Medical School University of East Anglia  Norwich UK"},{"name":"Department of Gastroenterology Norfolk and Norwich University Hospital NHS Foundation Trust  Norwich UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7748-2165","authenticated-orcid":false,"given":"Kate D.","family":"Lynch","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Royal Adelaide Hospital  Adelaide Australia"},{"name":"College of Health Adelaide University  Adelaide Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,21]]},"reference":[{"issue":"2","key":"e_1_2_12_2_1","doi-asserted-by":"crossref","first-page":"659","DOI":"10.1002\/hep.32771","article-title":"AASLD Practice Guidance on Primary Sclerosing Cholangitis and Cholangiocarcinoma","volume":"77","author":"Bowlus C. 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