INFLAMMATORY BOWEL DISEASE AND RHEUMATOID ARTHRITIS

Abstract

Abstract Inflammatory bowel disease has been associated with arthritis since the late 20th century, but it was not until a few decades ago that IBD-associated arthritis was recognized as a distinct pathology independent from rheumatoid arthritis (RA). There is evidence that RA and other autoimmune conditions exist in higher rates in patients with IBD compared to the general population. This is an important distinction because of the different pathophysiology, clinical manifestations, management, complications, and prognosis of both diseases. METHODS: This study was reviewed and approved by the University of Pittsburgh Medical Center of Central Pennsylvania Review Board. Using Epic’s SlicerDicer function, patients with Inflammatory Bowel disease were identified using ICD-10 codes (K50 and K51). Those with incomplete information or duplicated were excluded obtaining a total of 3613 patients. Data collected included basic demographic information, surgical history, and the presence of Rheumatoid arthritis. We reported continuous variables as mean (range) and categorical variables as number (percent). We used Student’s t-test to analyze between group differences for the continuous variables. When it was determined that variances for the comparisons of continuous data were unequal, Welch-Satterthwaite t test statistics were used. We used chi-square test to analyze between group differences for the categorical variables. The Fisher exact test was employed when any of the expected frequencies was five or less. All tests were 2-sided with criterion for statistical significance at a p-value less than 0.05. All the analyses were done by SAS 9.4 (SAS Institute, Cary NC). RESULTS: Of the approximately 2.7 million adults in SlicerDicer, there were 3613 patients (0.13%) identified with Inflammatory Bowel disease. Patients with Ulcerative Colitis accounted for 37% of the total group (n= 1343) and 2270 patients (62.8%) had Crohn’s Disease. From the total, 2084 were women (57.68%) and 1529 (42.32%) were men. The mean age was 53.3 +- 18.5. 848 (23.47%) had documented Rheumatoid arthritis. Mortality was higher in patients with IBD and RA than those with IBD alone (7.31% vs 3.98%, p value= <0.0001). More than 90% of the patients were white (n=3321). CONCLUSION: IBD patients with RA have higher mortality than patients with IBD alone.