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Treating IBD when it comes with a liver complication just got a little clearer. A new meta-analysis found that advanced therapies like infliximab, vedolizumab, and tofacitinib achieved clinical remission in roughly a quarter of IBD patients who also have primary sclerosing cholangitis (PSC). The results are modest, but they suggest this tricky disease combo may be harder to treat than IBD alone — and that some therapies are better tolerated than others.
Treating IBD when it comes with a rare liver complication just got a little clearer. A systematic review and meta-analysis published in Alimentary Pharmacology & Therapeutics examined the safety and efficacy of advanced IBD therapies — infliximab, adalimumab, vedolizumab, and tofacitinib — in 394 patients who had both IBD and primary sclerosing cholangitis (PSC), a chronic liver disease that often co-occurs with IBD.
The findings were modest but informative: clinical remission rates hovered around 25–29%, while nearly half of patients achieved endoscopic response. Tofacitinib and vedolizumab had the best tolerability profiles, while adalimumab and infliximab saw higher discontinuation rates due to adverse events. Researchers also noted that PSC-IBD may represent a more treatment-resistant disease phenotype than IBD alone.
By the Numbers:
Why it matters: PSC-IBD is a complex, under-studied condition with limited treatment guidance. These findings give clinicians a clearer picture of what to expect from advanced therapies and highlight the need for dedicated clinical trials in this patient population.
