Abstract
Abstract Background It is well known that immune-mediated inflammatory diseases (IMIDs) are frequently diagnosed in patients with inflammatory bowel disease (IBD). However, few studies have taken into account whether the number of associated IMIDs influences IBD. Our aim was to evaluate the clinical, demographic, and drug needs of patients with IBD based on the number of other IMIDs they present. Methods Cross-sectional study that included patients treated at the IBD Unit of the Central University Hospital of Asturias (Spain) between August 2020 and December 2021. Demographic data and disease characteristics were collected and IMID diagnosis was confirmed in the medical records of each patient. Patients were split into three groups: non-IMID, 1-IMID, and two or more associated IMIDs. Hospitalizations, drugs and surgery requirement were analyzed. The comparison between groups was carried out using the Kruskal-Wallis test, and Pearson's Chi-square test or Fisher's exact test. When there was a significant difference between any of the groups, a post-hoc test was performed with p-value correction following the Benjamini and Hochberg method. Results A total of 1,620 patients were included in the analysis. 1,067 (66%) had no IMID, 394 (24%) had one IMID, and 159 (9.8%) had two or more IMIDs. Overall, the most frequent IMIDs were spondylarthritis (14%), psoriasis (7.5%), erythema nodosum (4.3%), intrinsic asthma (2.8%), and uveitis (2.5%). The presence of an IMID was associated with older age, longer duration of IBD, female sex, and Crohn's disease (Table 1). The use of steroids, immunomodulators, and biologics, as well as the need for hospitalizations, was higher in patients with several IMIDs. When we analyzed the groups of patients with one and with two or more IMIDs, the only significant differences were a longer duration of disease, a greater prevalence of Crohn's disease, and a higher use of steroids, immunomodulators, and biologics among patients with two or more IMIDs. The percentage of patients with joint (spondylarthritis, psoriasic arthritis, juvenile idiopathic arthritis), cutaneous (psoriasis, hidradenitis suppurative, erythema nodosum, pyoderma gangrenosum) and ocular (uveitis and episcleritis) IMIDs and intrinsic asthma was higher in the group with two or more IMIDs than in the group with one IMID. Conclusion 10% of patients with IBD have two or more associated IMIDs. The duration of IBD and the need to use steroids, immunomodulators and biologics is greater than in patients with one IMID.
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