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P647. 2-year incidence of new immune-mediated inflammatory diseases in patients with inflammatory bowel disease. The AQUILES study

Background

Objective: To describe the 2-year incidence of new immune-mediated inflammatory diseases (IMID) in patients with inflammatory bowel disease (IBD) recruited for the AQUILES study.

Methods

AQUILES was an observational study on 3 independent cohorts of patients aged ≥18 years with IBD, psoriasis or spondyloarthritis (SpA) recruited from IBD, rheumatology and dermatology offices of 15 hospitals in Spain. Patients were followed-up for 2 years. In the IBD cohort, the diagnosis of new IMID was based on reports from rheumatologists (SpA), dermatologists (psoriasis) or ophthalmologists (uveitis).

Results

A total of 341 IBD patients completed the 2-year follow-up (mean age: 39.6 years-old; 53% females, 27% with new and 73% with past diagnosis of IBD). The diagnoses were Crohn's disease (61%) and ulcerative colitis (38%). Some 16% had family history of IBD, and 15% showed extra-intestinal manifestations of IBD. At baseline, 14.4% had other IMID (10.6% SpA; 3.5% psoriasis; 1.5% uveitis and 0.6% pyoderma gangrenosum). During the 2-year follow-up period, there were 22 new diagnostics of other IMID in 21 patients (cumulative incidence: 6.5%, 95% CI: 3.7–9.2; incidence rate: 26 cases per 10,000 patients-year, 95% CI: 16–39). The incidence of each specific IMID is shown in Table 1. The incidence was similar in patients with Crohn's disease or ulcerative colitis (Table 2, p = NS). In the multivariate analysis, the incidence of new IMID was associated with the presence of family history of IBD (OR: 3.6, 95% CI: 1.4–9.4) and of extra-intestinal manifestations of IBD (OR: 1.8, 95% CI: 0.7–5.2).

Table 1. 2-year incidence of IMID in patients with IBD
New cases, nCumulative incidence (95% CI)Incidence rate per 10,000 patients-year (95% CI)
IMID, all226.5 (3.7–9.2)25.9 (16.0–39.0)
SpA, all154.4 (2.1–6.7)17.7 (10.0–29.0)
Enteropathic arthritis61.8 (0.2–3.3)7.1 (3.0–15.0)
Ankylosing spondylitis20.6 (0.1–2.1)2.4 (0.0–9.0)
Undifferentiated SpA61.8 (0.2–3.3)7.1 (3.0–15.0)
SAPHO syndrome10.3 (0.0–1.6)1.2 (0.0–7.0)
Psoriasis51.5 (0.5–3.4)5.9 (2.0–14.0)
Uveitis21.8 (0.2–3.3)2.4 (0.0–9.0)
Table 2. 2-year cumulative incidence of IMID in patients with Crohn's disease or ulcerative colitis (p = NS)
Incidence, number (%)
Crohn's disease (n = 206)Ulcerative colitis (n = 130)
IMID, all12 (5.8%)10 (7.7%)
SpA, all7 (3.4%)8 (6.2%)
Enteropathic arthritis4 (1.9%)2 (1.5%)
Ankylosing spondylitis1 (0.5%)1 (0.8%)
Undifferentiated SpA2 (1.0%)4 (3.1%)
SAPHO syndrome0 (0.0%)1 (0.8%)
Psoriasis3 (1.5%)2 (1.5%)
Uveitis2 (1.0%)0 (0.0%)

Conclusion

In the AQUILES study, the two-year incidence of new IMID in the IBD cohort was 6.5%. New diagnoses of IMID were more frequent in those patients with extra-intestinal manifestations and family history of IBD at baseline.

  • Written by:

    I. Marín-Jiménez1, V. García2, J. Pérez-Gisbert3, J.L. Pérez-Calle4, M. Luján5, S. Tabernero6, M. Andreu7, R. García de Vicuña8, B. Juliá9, L. Cea-Calvo9, F. Vanaclocha10, 1Gregorio Marañón Hospital, Gastroenterology, Madrid, Spain, 2Reina Sofia Hospital, IMIBIC, UCO, Gastroenterology, Córdoba, Spain, 3La Princesa Hospital, IP and CIBERehd, Gastroenterology, Madrid, Spain, 4Alcorcón Foundation Hospital, Gastroenterology, Madrid, Spain, 5Valencia General Hospital Consortium, Gastroenterology, Valencia, Spain, 6Príncipe de Asturias Hospital, Gastroenterology, Madrid, Spain, 7del Mar Hospital, Gastroenterology, Barcelona, Spain, 8La Princesa Hospital, IISP, Rheumatology, Madrid, Spain, 9Merck Sharp & Dohme de España, Medical Affairs, Madrid, Spain, 1012 de Octubre Hospital, Dermatology, Madrid, Spain