P646. Clinical and epidemiological features of patients with inflammatory bowel disease and extraintestinal manifestations associated
Inflammatory bowel disease (IBD) primarily affects the gastrointestinal tract, but throughout its evolution, patients may experience extraintestinal involvement. We aimed to describe the clinical and epidemiological characteristics and the extraintestinal manifestations (EIM) on IBD patients and to identify associated factors with their occurrence in our community.
A retrospective, observational and case–control study was performed. We identified the ulcerative colitis (UC) and Crohn's disease (CD) patients with EIM (cases) from Reina Sofia Hospital. We randomly matched each case with two IBD patients without EIM and with same age, sex and type of IBD (controls). We recruited a total of 342 patients (114 cases and 228 controls) from ENEIDA database. Demographic and epidemiological data related to the IBD and EIMs were collected. The analysis was carried out by Gstat Software 2.0.
We analyzed 342 patients with a mean age of 45.9 years (SD: 13.3) (cases) and 45.4 years (SD: 13.1) (controls). Mean age at IBD diagnosis: 33.6 years (SD: 14.1) and 35.6 years (SD: 14.4) respectively, with no significant differences by type of IBD. In both groups, 50.8% were female, 36.5% patients with UC and 68.4% with CD. Proctosigmoiditis in UC and ileocolic disease in CD were the most frequent location. Extraintestinal involvement: osteoarticular (48.2%), muco-cutaneous (30%), ocular (16.4%), haematologic (2.8%) and biliary manifestations (1.4%). Most frequent EIM: erythema nodosum in CD (79.1%), sacroiliitis and spondylitis in UC (73.0%) (p = 0.05). We identified higher prevalence of EIM at diagnosis of IBD in CD (22.3%) vs UC (11.6%) (p = 0.09). Patients with EIM required higher cares by specialist (60.8%), greater needed for immunosuppressive (11.1%) and anti-TNF (5.5%) therapy. Factors associated with the development of EIM were: ileocolic location in CD (p = 0.04), presence of granulomas in CD biopsy (p = 0.002) steroid-dependence (p = 0.01) and use of biological therapy (p = 0.02). Factors such as first-degree family history (p = 0.05), needed of at least one hospitalization (p = 0.09), intestinal resection (p = 0.09) and use of steroids in UC (p = 0.06) showed a higher risk but no significance was reached.
The osteoarticular and mucocutaneous manifestations were the most frequent EIM. Ileocolic location and presence of granulomas in CD, steroid-dependence and needed for biological therapy were associated to increased risk of EIM. Further studies on larger cohort of patients are required to develop a predictive model to identify risk patients and to treat them early.