D0349 - Increased Risk of Gout in Patients With Inflammatory Bowel Disease: A Population-Based Study

Tuesday, October 25, 2022

10:00 AM – 12:00 PM ET

Location: Crown Ballroom

Presenting Author(s)

OH

Osama Hamid, MD, MRCPI

Cleveland Clinic
Cleveland, OH

Osama Hamid, MD, MRCPI¹, Rama Nanah, MD¹, Ahmed Eltelbany, MD, MPH¹, Khaled Alsabbagh Alchirazi, MD¹, Abdul Mohammed, MD¹, Miguel Regueiro, MD²
¹Cleveland Clinic, Cleveland, OH; ²Cleveland Clinic Main Campus, Cleveland, OH

Introduction: Arthritis is a recognized extra-intestinal manifestation of inflammatory bowel disease (IBD). Studies show altered uric acid metabolism in patients with IBD. Gout is a crystal deposition disease characterized by hyperuricemia that exceeds the limit of urate solubility and causes tissue depositions leading to inflammatory arthritis. This study aims to investigate the association between IBD and gout.

Methods: We used a commercial database (Explorys Inc, Cleveland, OH), an aggregate of Electronic Health Record data from 26 US healthcare systems. We identified adults with the diagnosis of Crohn’s disease (CD), and ulcerative colitis (UC) from 1999 to 2022. In this cohort, we identified patients who developed a clinical diagnosis of gout. We collected demographic data including age, gender and race. We also identified patients with diagnosed IBD-associated arthritis and those who had intestinal resection. Risk factors associated with gout like chronic kidney disease (CKD), malignancy, alcohol and smoking are collected. Univariate and multivariate analysis are used to assess the association of CD and UC with gout, accounting for risk factors.

Results: Out of the 69,260,780 adult patients in the database, we identified 209,020 patients with UC (0.30%) of whom 9130 had gout (4.3%). In addition, 249,480 had CD (0.36%) of whom 14000 had gout (5.61%). The majority of patients were > 65 years old. Males were more prevalent in the UC and gout groups than in the CD and gout groups (58% vs 51%). The majority were Caucasians across the two groups. Adjusting for age, gender, CKD, malignancy, IBD-associated arthritis, intestinal resection, alcohol and smoking, CD is significantly associated with gout (OR 1.68 CI [1.60-1.75]). UC is also found to be significantly associated with gout (OR 1.38 CI [1.31-1.44]). In subgroup analysis in both groups against intestinal resection, CD group who had intestinal reaction had higher association with gout vs no surgery (OR 2.34 [2.25-2.43]). Similar increase is observed in UC group who had intestinal resection (OR 1.53 [1.49-1.56]).

Discussion: In this large retrospective study, we found that IBD is strongly associated with gout with higher correlation observed with CD. Intestinal resection is associated with an increase in the risk of gout. Patients with IBD who present with new-onset arthritis should be investigated for gout.

Figure: Title: Forest Plots for Adjusted Odds Ratio for Crohn’s disease and Ulcerative Colitis

	UC + Gout	CD + Gout
Total Cohort	9130	14000
Age 18-65	2740 (30%)	5340 (38%)
Age >65	6350 (70%)	5870 (61%)
Gender
Male	5290 (58%)	7120 (51%)
Female	3820 (42%)	6850 (49%)
Race
Caucasian	7480 (82%)	11570 (83%)
AA	960 (11%)	1220 (9%)
Asian	110 (1%)	350 (3%)
Hispanic	30 (0.3%)	120 (1%)
Unknown	550 (6%)	740 (5%)

Table: Title: Demographic characteristics of IBD patients with gout

Footnote: UC: Ulcerative Colitis; CD: Crohn’s disease; AA: African American

Disclosures:

Osama Hamid indicated no relevant financial relationships.

Rama Nanah indicated no relevant financial relationships.

Ahmed Eltelbany indicated no relevant financial relationships.

Khaled Alsabbagh Alchirazi indicated no relevant financial relationships.

Abdul Mohammed 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.

Osama Hamid, MD, MRCPI¹, Rama Nanah, MD¹, Ahmed Eltelbany, MD, MPH¹, Khaled Alsabbagh Alchirazi, MD¹, Abdul Mohammed, MD¹, Miguel Regueiro, MD². D0349 - Increased Risk of Gout in Patients With Inflammatory Bowel Disease: A Population-Based Study, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.