A0369 - Prevalence of Vitiligo Among IBD and Celiac Disease Patients: Results From a Population-Based Study

Sunday, October 23, 2022

5:00 PM – 7:00 PM ET

Location: Crown Ballroom

Presenting Author(s)

Khaled Alsabbagh Alchirazi, MD

Cleveland Clinic
Cleveland, OH

Khaled Alsabbagh Alchirazi, MD¹, Ahmed Eltelbany, MD, MPH¹, Abdul Mohammed, MD¹, Ashraf Almomani, MD², Osama Hamid, MD, MRCPI¹, Osama Abu-Shawer, MD, MS¹, Alberto Rubio Tapia, MD¹, Miguel Regueiro, MD³
¹Cleveland Clinic, Cleveland, OH; ²Cleveland Clinic Foundation, Cleveland, OH; ³Cleveland Clinic Main Campus, Cleveland, OH

Introduction: Inflammatory bowel disease (IBD) is associated with skin manifestation; Erythema nodosum and pyoderma gangrenosum being the most common but other skin disorder have been reported in IBD. Vitiligo is a rare autoimmune disease that is diagnosed based on clinical findings and examining the skin by wood lamp that reveals depigmentation patches. In the past, case studies (Shafa S et al) and case reports have suggested a link between Vitiligo and IBD. Using a large database, we aim to describe the epidemiology and risk of Vitiligo in IBD patients.

Methods: We used a multi-instituitional database (Explorys Inc, Cleveland, OH), an aggregate of electronic health record data from 26 US healthcare systems. In this database, we identified patients with a Systemized Nomenclature of Medicine Clinical Terms diagnosis of IBD, CD, and vitiligo from 1999 to the present. We assessed the association of vitiligo in IBD patients without CD and CD patients without IBD and compared them with individuals with neither IBD nor CD.

Results: Out of the 70,383,890 patients in the database, we identified a total of 50,020 patients with vitiligo (0.1%), 412,950 patients with IBD (0.6%), and 136,690 patients with CD (0.2%). Among those with vitiligo, there were 450 (0.4%) CD patients (without IBD), 880 (0.3%) IBD patients (without CD), 50 (0.2%) patients with both celiac and IBD, and 48,640 (0.07%) patients with neither CD nor IBD (control group). The prevalence of vitiligo was 0.4% in celiac disease (without IBD) and 0.3% in IBD (without CD). The risk of vitiligo was higher in the CD-only group [OR 5.65 (5.15–6.20)] and IBD-only group [OR 3.24 (3.03–3.46)] compared to the control group (table 1). In the IBD-only group, vitiligo was more commonly associated with females compared to males [OR 1.44 (1.19–1.74), P< 0.0001], in adults aged 18–65 compared to elderly patients [2.52 (2.08–3.06), P< 0.0001], and in Caucasians compared to non-Caucasians (OR 9.0 [7.25–11.17], P< 0.0001) (Figure 1).

Discussion: Utilizing a large population database, we report a distinct increased association of vitiligo in IBD and CD. Further studies are necessary to confirm this association and discover the mechanism behind this association.

Figure: Figure 1. Gender-, Age- and Race-Based Prevalence ratio of vitiligo in individuals with IBD without history of celiac disease in the United States.

OR, 95% CI, p-value

*Compared to patients with vitiligo without celiac nor IBD

Vitiligo in Celiac disease

(Excluding those with IBD)

OR 5.65 (5.15-6.20), P< 0.0001

Vitiligo in IBD

(Excluding those with celiac)

OR 3.24 (3.03-3.46), P< 0.0001

Table: Table 1. Odd’s ratio comparing the prevalence of vitiligo in celiac disease and in IBD to patients with vitiligo without celiac or IBD. Univariate analysis used to calculate OR. OR; odds ratio, CI; confidence interval, IBD; Inflammatory bowel disease.

Disclosures:

Khaled Alsabbagh Alchirazi indicated no relevant financial relationships.

Ahmed Eltelbany indicated no relevant financial relationships.

Abdul Mohammed indicated no relevant financial relationships.

Ashraf Almomani indicated no relevant financial relationships.

Osama Hamid indicated no relevant financial relationships.

Osama Abu-Shawer indicated no relevant financial relationships.

Alberto Rubio Tapia indicated no relevant financial relationships.

Miguel Regueiro: Abbvie – Advisory Committee/Board Member, Consultant. Abbvie – Grant/Research Support. ALFASIGMA, S.p.A. – Advisory Committee/Board Member. Allergan – Advisory Committee/Board Member. Amgen – Advisory Committee/Board Member. BMS – Grant/Research Support. Bristol Meyer Squibb – Advisory Committee/Board Member, Consultant. CC360 – Royalties. Celgene – Advisory Committee/Board Member. CME Outfitters – CME Companies. Cornerstones – CME Companies. Crohn’s and Colitis Foundation as Editor-in-Chief – Royalties. Genentech – Advisory Committee/Board Member. Genentech – Grant/Research Support. Gilead – Advisory Committee/Board Member. Gilead – Grant/Research Support. HMPGlobal – CME Companies. Imedex, GI Health Foundation (GiHF) – CME Companies. Janssen – Advisory Committee/Board Member, Consultant. Janssen – Grant/Research Support. Lilly – Grant/Research Support. MDEducation – CME Companies. Medscape – CME Companies. Miraca Labs – Advisory Committee/Board Member. MJH life sciences – CME Companies. Pfizer – Advisory Committee/Board Member, Consultant. Prometheus – Advisory Committee/Board Member. Remedy – CME Companies. Salix – Advisory Committee/Board Member. Seres – Advisory Committee/Board Member. Takeda – Advisory Committee/Board Member, Consultant. TARGET Pharma Solutions – Advisory Committee/Board Member. UCB – Grant/Research Support. WebMD – CME Companies. Wolters Kluwer Health as Author/Editor of UpToDate – Royalties.

Khaled Alsabbagh Alchirazi, MD¹, Ahmed Eltelbany, MD, MPH¹, Abdul Mohammed, MD¹, Ashraf Almomani, MD², Osama Hamid, MD, MRCPI¹, Osama Abu-Shawer, MD, MS¹, Alberto Rubio Tapia, MD¹, Miguel Regueiro, MD³. A0369 - Prevalence of Vitiligo Among IBD and Celiac Disease Patients: Results From a Population-Based Study, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.