P230 Clinical characteristics, risk factors and management of patients with inflammatory bowel disease and hidradenitis suppurativa: a nationwide multicenter study of the GETECCU ENEIDA registry

Abstract

Abstract Background Hidradenitis suppurativa (HS) is a relapsing skin disease. Evidence supports an association between HS and inflammatory bowel disease(IBD). Aim, to explore the characteristics of patients with IBD and HS(IBD-HS) and to compare with IBD patients without HS(controls). Methods Retrospective, observational, multi-centre, case-control study of the Spanish nationwide ENEIDA registry. We selected all IBD patients with HS confirmed by a dermatologist. Patients were matched 2:1 by hospital and year of diagnosis with controls. A form regarding HS was completed by researchers. Efficacy of HS therapy was defined as≥50% reduction in the number of inflammatory skin lesions. Results A total of 273 patients(mean age 43±12 years) with IBD-HS and 546 matched controls(mean age 53±15) were included. Diagnosis of IBD preceded HS diagnosis in 208 IBD-HS patients(77%). Female sex(62 vs 44%, p=0.0001), smoking habit(45 vs 15%, p=0.0001), Crohn disease(CD) (82 vs 54%, p=0.0001), ileocolonic CD location(46 vs 36%, p=0.0001), perianal disease(55 vs 20%, p=0.0001), extensive ulcerative colitis (59 vs 45% p < 0.05) and extraintestinal manifestations(EIM)(joint and cutaneous)(38 vs 17, p=0.0001) were more frequent in IBD-HS than among controls. Body mass index(BMI) was higher in IBD-HS vs controls(28 ±7 vs 26±4, p=0.05). Hypotiroidism (4,4 vs 1,1%, p < 0.05) and psychiatric disorders(18% vs 2%, p< 0.05) were more prevalent in IBD-HS cohort. More IBD-HS patients underwent abdominal(29 vs 23, p=0,04) and perianal (35 vs 8%, p=0.000) IBD-related surgeries. The use of biologics was more frequent in IBD-HS patients(73 vs 54%, p=0.0001). HS characteristics are shown in Table 1. HS affected mainly axillary(57%) and inguinal regions (57%) followed by genital(42%), perianal(31%), buttocks(27%) and breast(17%). Paradoxical HS was observed in 19(7%) IBD-HS patients, associated to infliximab(IFX)(4, 21%), adalimumab(ADA)(11, 58%) and ustekinumab (UST)(3,16%), leading to stop them in 7(41%) patients. Regarding HS therapy, the efficacy to treatments was: IFX(30/49, 59%), ADA(49/86, 57%), UST(31/49, 69%), and other biologic(5/14, 36%). Conclusion In the largest cohort of IBD-HS patients ever reported, female sex, BMI, CD, smoking, and perianal disease are risk factors for HS among IBD patients. Skin and joint EMI, abdominal and perianal IBD surgeries and need of biologic therapy are more frequent among IBD-HS patients than in controls. Notably, more than half of these patients responded to anti-TNF while 2 thirds of those treated with UST exhibited a favorable response regarding HS lesions.