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P292 Immunomodulator and biological therapy are increased in inflammatory bowel disease patients with associated immune-mediated inflammatory diseases

M. J. Garcia Garcia*1, M. Pascual Mato1, C. Del Pozo Calzada1, L. Rasines Perez1, B. Castro Senosiain1, J. Crespo Garcia1, M. Rivero Tirado1

1Marques De Valdecilla Universitary Hospital, Gastroenterology, Santander, Spain

Background

Immune-mediated diseases (IMIDs) include a heterogenous group of chronic diseases that are characterised by the loss of the immune system tolerance causing inflammation and organs tissue damage. Inflammatory bowel diseases (IBD) belong to IMIDs group together with other autoimme diseases. Literature data showed an IMID prevalence of 9–15% in IBD, depending of the region studied. The objective of our study is to describe the prevalence and influence of IMIDs in IBD.

Methods

A retrospective and descriptive study was designed to evaluate the influence of IMIDs in IBD. In total, 1448 IBD patients were studied to evaluate the different clinical characteristics and evolution course of the disease depending on the associated IMIDs

Results

In total, 1448 patients were analysed of whom 46.96% (n = 680) were diagnosed with Crohn’s disease, 48.34% (n = 700) with ulcerative colitis and 4.7% (n = 68) with IBD unclassified. A IMID prevalence of 25.69% (n = 372) was present in IBD patients compared with 74.31% (n = 1076) of IBD patients without IMIDs. The most prevalent IMIDs were intrinsic asthma and skin psoriasis following rheumatoid conditions.

Prevalence of IMID’s in inflammatory bowel diseases.

An increased risk of IMIDs was observed in IBD women (OR 1.37 (IC 95%: 1.07–1.75) p = 0.009). Furthermore, more proportion of IMIDs patients was observed in Crohn’s disease compared with ulcerative colitis (OR 1.32 (IC 95% 1.03–1.70) p = 0.02). It is important to highlight that IMIDs patients had a higher intestinal perforation risk than other patients (OR 2.72 (IC 95%: 1.04–7.09), p = 0.04). Extraintestinal manifestations were associated with IMIDs group and they also required more immunomodulator (OR 1.70 (IC 95%: 1.33–2.17), p = <0.01) and biological therapy (OR 2.03 (IC 95%: 1.56–2.63) p ≤ 0.01).

Odss ratio of clinical characteristics and therapy.

No statistically significant association was observed between IMIDs patients and clinical characteristics of the disease or IMIDs patients and smoking habit. Age or evolution time of the disease was neither correlated to suffering IMIDs.

Conclusion

(1) There is an increased IMIDs prevalence in IBD patients. (2) Crohn’s disease patients and women have a higher risk of associated IMIDs to their IBD. (3) IBD patients with associated IMIDs require more immunomodulator therapy or biological therapy to control their disease, probably caused by a more aggressive course of IBD. (4) More studies are necessary to increase the knowledge in IBD patients with associated IMIDs.