S0661 The Prevalence of Peripheral Vascular Disease Is Increased in Inflammatory Bowel Disease, but Decreased After Anti-TNF Treatment: A Population-Based Study

Abstract

INTRODUCTION: Patients with inflammatory bowel disease (IBD) might be at increased risk of peripheral vascular disease (PVD) due to the similarities in the ongoing paradigm of inflammation. Anti-tumor necrosis factor (anti-TNF) has been shown to decrease the endothelial function responsible for atherosclerotic vascular disease in rheumatoid arthritis. However, in IBD this relation is not clear. We sought to investigate the prevalence of PVD in IBD patients with and without anti-TNF. METHODS: We used a commercial database (Explorys Inc, Cleveland, OH) which includes electronic health record data from 26 major integrated US healthcare systems. Based on Systematized Nomenclature Of Medicine—Clinical Terms (SNOMED-CT), we identified all patients (age >18 years) who were diagnosed with either CD or UC between 2015 and 2020 who were treated with any type of anti-TNFs. We investigated the prevalence of PVD in IBD patients compared to patients with no IBD. Also, we compared the prevalence between IBD patients with and without anti-TNF therapy. RESULTS: Of the 32, 411,600 individuals in the database from 2015 to present, we identified 139,710 (0.43%) patients with CD and 114,770 (0.35%) patients with UC, of whom 24,160 (17.3%) and 8,080 (7%) patients received anti-TNFs, respectively. The prevalence of PVD was 20.5% and 21.8% for CD and UC, respectively, compared to 9.6% in individuals without IBD, P < 0.001 to all. The prevalence of PVD was significantly lower in anti-TNF treated CD patients (7.8%) compared to those who did not receive anti-TNF (22.1%). Similarly, anti-TNF treated UC patients were significantly less likely to have PVD (7.5%) compared to UC patients who did not receive anti-TNF therapy (22.3%), (P < 0.001 to all). CONCLUSION: This is the largest individual study investigating prevalence of PVD in patients with IBD with and without anti-TNF therapy. We found that IBD patients who were treated with anti-TNF were significantly less likely to have PVD when compared to IBD individuals who were never treated with anti-TNF.Figure 1.: The prevalence of Peripheral Vascular Disease in patients with inflammatory bowel disease with and without anti-TNF therapy.Table 1.: Type of Anti-TNF therapy in inflammatory bowel disease patients with Peripheral Vascular Disease