E0192 - Prevalence of Barrett's Esophagus in Patients With Autoimmune Disease

Akash Khurana, MD¹, Syed Ahmad Adil, MD², Vibhu Chittajallu, MD³, Abbinaya Elangovan, MD³, Amitabh Chak, MD^4
1University Hospitals of Cleveland, Cleveland, OH; ²University Hospitals/CMC, Cleveland, OH; ³University Hospitals Cleveland Medical Center/ Case Western Reserve University, Cleveland, OH; ⁴University Hospitals, Digestive Health Institute, Cleveland, OH

Introduction: Systemic lupus erythematosus (SLE), Rheumatoid arthritis (RA) and Sjögren’s syndrome (SS) are multi-system rheumatologic diseases with known esophageal manifestations such as gastroesophageal reflux disease (GERD) from impaired peristalsis, decreased lower esophageal sphincter tone, and increased visceral hypersensitivity. However, there are no data on the prevalence of Barrett’s esophagus (BE).

Methods: The aim of this study was to investigate the prevalence of Barrett’s esophagus in patients with SLE, RA and SS. Data were collected from a commercial database (Explorys Inc, Cleveland, OH), an aggregate of electronic health records data from 27 integrated healthcare systems in the US between 4/2017-4/2022. We identified patients with SLE based on Systematized Nomenclature of Medicine – Clinical Terms (SNOMED-CT). We compared the prevalence of BE at least 30 days after a diagnosis of each autoimmune condition to a control cohort without the autoimmune disease. We sub-categorized using demographics including gender, race, age, and BMI. We also included data on tobacco use, alcohol use, and proton pump inhibitor (PPI) therapy.

Results: Of the 31,502,430 patients in the database, we identified 120,040 cases of SLE, 371,640 cases of RA, and 77,010 cases of SS. There was a greater female to male ratio for all three autoimmune diseases (Table 1). Prevalence of BE in SLE was 1.3% (OR 2.33, CI 2.21-2.45), in RA was 1.5% (OR 2.88, CI 2.80-2.96), and in SS was 1.7% (3.24, CI 3.07-3.42). History of tobacco use was reported in 11.2%, 14.1%, and 11.9% of patients with SLE, RA, and SS, respectively, compared to 3.4% of patients without the autoimmune disease.

Among patients with tobacco use, the risk of BE was comparable between those with SLE, RA and SS and those without SLE, RA, or SS (SLE OR 0.95, RA OR 1.11, SS OR 1.20). However, among those without tobacco use, the risk of BE was higher among the patients with SLE, RA, and SS compared to patients without SLE, RA or SS (SLE OR 2.33, RA OR 2.77, SS OR 3.28) (Table 2). PPI use for BE was reported in 91.3%, 91.4%, and 90.3% of patients with SLE, RA, and SS, respectively, compared to 81.1%, 83.6%, and 83.9%, without the autoimmune disease.

Discussion: In a large population-based study using a commercial database, patients with SLE, RA, and SS had a significant association with BE after a diagnosis of the autoimmune disease. This association was stronger in patients with each autoimmune disease without tobacco use.




Disclosures:


Akash Khurana, MD¹, Syed Ahmad Adil, MD², Vibhu Chittajallu, MD³, Abbinaya Elangovan, MD³, Amitabh Chak, MD⁴. E0192 - Prevalence of Barrett's Esophagus in Patients With Autoimmune Disease, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.