{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T11:15:26Z","timestamp":1793445326251,"version":"4.5.0"},"reference-count":56,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2021,1,1]],"date-time":"2021-01-01T00:00:00Z","timestamp":1609459200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Therap Adv Gastroenterol"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:sec><jats:title>Background:<\/jats:title><jats:p> Patients with Crohn\u2019s disease (CD) are at increased risk of co-occurring immune-mediated inflammatory diseases (IMIDs). As discrepancy exists regarding the phenotypic presentation of CD among patients with such co-occurring IMIDs, we aimed to conduct a systematic review with meta-analysis characterizing the phenotype of CD among this subgroup of patients. <\/jats:p><\/jats:sec><jats:sec><jats:title>Methods:<\/jats:title><jats:p> PubMed, Embase, and Scopus were searched from their earliest records to October 2019 for studies reporting the behavior and localization of CD according to the Vienna or Montreal Classifications and CD-related surgery in patients with co-occurring IMIDs. These studies were the subject of a random effect meta-analysis. <\/jats:p><\/jats:sec><jats:sec><jats:title>Results:<\/jats:title><jats:p> After reviewing 24,413 studies, we identified a total of 23 studies comprising 1572 and 35,043 CD patients with and without co-occurring IMIDs, respectively, that fulfilled our inclusion criteria. Overall, patients with co-occurring IMIDs were more likely to have upper gastrointestinal inflammation than were patients without co-occurring IMIDs [relative risk (RR)\u2009=\u20091.49 (95% confidence interval (CI) 1.09\u20132.04), p\u2009=\u20090.01, I<jats:sup>2<\/jats:sup>\u2009=\u20097%]. In addition, presence of primary sclerosing cholangitis (PSC) was associated with a lower occurrence of ileal affection [RR\u2009=\u20090.44 (95% CI 0.24\u20130.81), p\u2009&lt;\u20090.01, I<jats:sup>2<\/jats:sup>\u2009=\u200932%], increased occurrence of colonic affection [RR\u2009=\u20091.78 (95% CI 1.33\u20132.38), p\u2009&lt;\u20090.01, I<jats:sup>2<\/jats:sup>\u2009=\u200932%] and an increased likelihood of non-stricturing and non-penetrating behavior [RR\u2009=\u20091.43 (95% CI 0.97\u20132.11), p\u2009=\u20090.07, I<jats:sup>2<\/jats:sup>\u2009=\u200986%]. The latter reached significance when cumulating different IMIDs [RR\u2009=\u20091.30 (95% CI 1.09\u20131.55), p\u2009&lt;\u20090.01, I<jats:sup>2<\/jats:sup>\u2009=\u200988%]. CD patients with PSC also underwent fewer CD-related surgeries [RR\u2009=\u20090.55 (95% CI 0.34\u20130.88), p\u2009=\u20090.01, I<jats:sup>2<\/jats:sup>\u2009=\u20090%], irrespective of CD location or behavior. <\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion:<\/jats:title><jats:p> This study emphasizes that CD patients with co-existing PSC are likely to have a unique inflammatory distribution primarily confined to the colon, while patients with IMIDs in general have higher likelihood of affection of upper gastrointestinal tract and a non-stricturing and non-penetrating behavior. As such a phenotype of CD is typically associated with a milder disease course; future studies are needed to confirm these results. <\/jats:p><\/jats:sec>","DOI":"10.1177\/17562848211004839","type":"journal-article","created":{"date-parts":[[2021,6,22]],"date-time":"2021-06-22T07:21:04Z","timestamp":1624346464000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":7,"title":["Systematic review and meta-analysis: the impact of co-occurring immune-mediated inflammatory diseases on the disease localization and behavior of Crohn\u2019s disease"],"prefix":"10.1177","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0323-7030","authenticated-orcid":false,"given":"Mohamed","family":"Attauabi","sequence":"first","affiliation":[{"name":"Gastrounit, Medical Section, Copenhagen University Hospital Hvidovre, Kettegaard Alle 30, Denmark"},{"name":"Copenhagen Center for Inflammatory Bowel Disease in Children, Adolescents and Adults, University of Copenhagen, Hvidovre Hospital, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mirabella","family":"Zhao","sequence":"additional","affiliation":[{"name":"Gastrounit, Medical Section, Copenhagen University Hospital, Hvidovre, Denmark"},{"name":"Copenhagen Center for Inflammatory Bowel Disease in Children, Adolescents and Adults, University of Copenhagen, Hvidovre Hospital, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Flemming","family":"Bendtsen","sequence":"additional","affiliation":[{"name":"Gastrounit, Medical Section, Copenhagen University Hospital, Hvidovre, Denmark"},{"name":"Copenhagen Center for Inflammatory Bowel Disease in Children, Adolescents and Adults, University of Copenhagen, Hvidovre Hospital, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johan","family":"Burisch","sequence":"additional","affiliation":[{"name":"Gastrounit, Medical Section, Copenhagen University Hospital, Hvidovre, Denmark"},{"name":"Copenhagen Center for Inflammatory Bowel Disease in Children, Adolescents and Adults, University of Copenhagen, Hvidovre Hospital, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2021,6,22]]},"reference":[{"key":"bibr1-17562848211004839","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2007.01215.x"},{"key":"bibr2-17562848211004839","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2005.06.021"},{"key":"bibr3-17562848211004839","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2019.03.040"},{"key":"bibr4-17562848211004839","doi-asserted-by":"publisher","DOI":"10.1093\/ecco-jcc\/jjv213"},{"key":"bibr5-17562848211004839","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2004.046615"},{"key":"bibr6-17562848211004839","doi-asserted-by":"publisher","DOI":"10.1097\/MIB.0b013e3182802893"},{"key":"bibr7-17562848211004839","author":"Attauabi M","journal-title":"Inflamm Bowel Dis"},{"key":"bibr8-17562848211004839","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-151-4-200908180-00135"},{"key":"bibr9-17562848211004839","unstructured":"Higgins J, Green S (eds). Cochrane handbook for systematic reviews of interventions. Version 5. The Cochrane Collaboration, www.handbook.cochrane.org (2011, accessed 06 January 2021)."},{"key":"bibr10-17562848211004839","doi-asserted-by":"publisher","DOI":"10.3109\/00365528909091339"},{"key":"bibr11-17562848211004839","author":"Gomoll\u00f3n F","journal-title":"J Crohns Colitis"},{"key":"bibr12-17562848211004839","unstructured":"Ryan R, Synnot A, Prictor M, et al. Cochrane Consumers and Communication La Trobe University: data extraction template [Internet]. La Trobe University. Journal contribution, https:\/\/doi.org\/10.26181\/5b57cfd711743 (accessed 23 May 2020)."},{"key":"bibr13-17562848211004839","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2005.082909"},{"key":"bibr14-17562848211004839","doi-asserted-by":"publisher","DOI":"10.1155\/2005\/269076"},{"key":"bibr15-17562848211004839","unstructured":"GA Wells B, O\u2019Connell D, Peterson J, et al. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses, http:\/\/www.ohri.ca\/programs\/clinical_epidemiology\/oxford.asp (accessed 23 May 2020)."},{"key":"bibr16-17562848211004839","doi-asserted-by":"publisher","DOI":"10.1002\/ibd.21051"},{"key":"bibr17-17562848211004839","doi-asserted-by":"publisher","DOI":"10.5152\/tjg.2019.17291"},{"key":"bibr18-17562848211004839","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0211554"},{"key":"bibr19-17562848211004839","first-page":"25","volume":"20","author":"Iny O","year":"2018","journal-title":"Isr Med Assoc J"},{"key":"bibr20-17562848211004839","doi-asserted-by":"publisher","DOI":"10.1097\/MCG.0b013e31829455b5"},{"key":"bibr21-17562848211004839","doi-asserted-by":"publisher","DOI":"10.1097\/DCR.0b013e31822bbcc1"},{"key":"bibr22-17562848211004839","volume":"95","author":"Liu S","year":"2016","journal-title":"Medicine"},{"key":"bibr23-17562848211004839","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2017.07.033"},{"key":"bibr24-17562848211004839","doi-asserted-by":"publisher","DOI":"10.1093\/ecco-jcc\/jjx126"},{"key":"bibr25-17562848211004839","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2013.20"},{"key":"bibr26-17562848211004839","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0210436"},{"key":"bibr27-17562848211004839","doi-asserted-by":"publisher","DOI":"10.1093\/ecco-jcc\/jjy061"},{"key":"bibr28-17562848211004839","doi-asserted-by":"publisher","DOI":"10.1177\/1756284819865142"},{"key":"bibr29-17562848211004839","doi-asserted-by":"publisher","DOI":"10.1097\/01.MIB.0000442011.60285.68"},{"key":"bibr30-17562848211004839","doi-asserted-by":"publisher","DOI":"10.1097\/MEG.0b013e3283583e5c"},{"key":"bibr31-17562848211004839","doi-asserted-by":"publisher","DOI":"10.1177\/1352458513515081"},{"key":"bibr32-17562848211004839","doi-asserted-by":"publisher","DOI":"10.1002\/ibd.22938"},{"key":"bibr33-17562848211004839","doi-asserted-by":"publisher","DOI":"10.1111\/apt.13940"},{"key":"bibr34-17562848211004839","doi-asserted-by":"publisher","DOI":"10.1097\/MIB.0000000000001169"},{"key":"bibr35-17562848211004839","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0b013e318187cc9c"},{"key":"bibr36-17562848211004839","doi-asserted-by":"publisher","DOI":"10.1097\/MEG.0000000000000747"},{"key":"bibr37-17562848211004839","doi-asserted-by":"publisher","DOI":"10.1093\/ecco-jcc\/jjz094"},{"key":"bibr38-17562848211004839","doi-asserted-by":"publisher","DOI":"10.1016\/j.crohns.2011.07.015"},{"key":"bibr39-17562848211004839","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2010.235408"},{"key":"bibr40-17562848211004839","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(02)11861-7"},{"key":"bibr41-17562848211004839","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v24.i28.3171"},{"key":"bibr42-17562848211004839","doi-asserted-by":"publisher","DOI":"10.5009\/gnl16510"},{"key":"bibr43-17562848211004839","doi-asserted-by":"publisher","DOI":"10.1016\/j.dld.2010.10.015"},{"key":"bibr44-17562848211004839","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(02)07374-9"},{"key":"bibr45-17562848211004839","doi-asserted-by":"publisher","DOI":"10.1084\/jem.20041035"},{"key":"bibr46-17562848211004839","doi-asserted-by":"publisher","DOI":"10.1111\/apt.14525"},{"key":"bibr47-17562848211004839","doi-asserted-by":"publisher","DOI":"10.1111\/apt.14829"},{"key":"bibr48-17562848211004839","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2019.05.013"},{"key":"bibr49-17562848211004839","doi-asserted-by":"publisher","DOI":"10.1038\/ng.145"},{"key":"bibr50-17562848211004839","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2009.11.046"},{"key":"bibr51-17562848211004839","doi-asserted-by":"publisher","DOI":"10.1155\/2003\/391308"},{"key":"bibr52-17562848211004839","doi-asserted-by":"publisher","DOI":"10.1097\/00004836-199504000-00011"},{"key":"bibr53-17562848211004839","doi-asserted-by":"publisher","DOI":"10.1016\/j.crohns.2013.05.007"},{"key":"bibr54-17562848211004839","doi-asserted-by":"publisher","DOI":"10.1177\/2050640618761703"},{"key":"bibr55-17562848211004839","doi-asserted-by":"publisher","DOI":"10.1016\/j.crohns.2011.11.020"},{"key":"bibr56-17562848211004839","doi-asserted-by":"publisher","DOI":"10.1111\/liv.13548"}],"container-title":["Therapeutic Advances in Gastroenterology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/17562848211004839","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/17562848211004839","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/17562848211004839","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,2]],"date-time":"2025-03-02T03:52:55Z","timestamp":1740887575000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/17562848211004839"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,1]]},"references-count":56,"alternative-id":["10.1177\/17562848211004839"],"URL":"https:\/\/doi.org\/10.1177\/17562848211004839","relation":{},"ISSN":["1756-2848","1756-2848"],"issn-type":[{"value":"1756-2848","type":"print"},{"value":"1756-2848","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,1]]},"article-number":"17562848211004839"}}