A0386 - Impact of Biologics Therapy on the Prevalence of Erectile Dysfunction Among Patients With Inflammatory Bowel Disease: A Nationwide Population-Based Study

Sunday, October 23, 2022

5:00 PM – 7:00 PM ET

Location: Crown Ballroom

Presenting Author(s)

Ahmed Eltelbany, MD, MPH

Cleveland Clinic
Cleveland, OH

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

Introduction: Erectile dysfunction (ED) is a well-established comorbidity of Inflammatory bowel disease (IBD). However, the connection between the two diseases remains unclear. Previous studies have suggested that chronic inflammation resulting in endothelial dysfunction maybe a contributing factor in the pathology of ED. Biologics have been shown to decrease inflammation among IBD patients. Therefore, we sought to investigate the prevalence of ED among individuals with IBD in a large national claims database and assess if biologics therapy may affect the risk of ED in patients with IBD.

Methods: We used the IBM Explorys clinical database which includes over 74 million de-identiﬁed unique patients across 300 hospitals in the United States. Patients were identiﬁed using SNOMED and ICD codes. We identified all male patients (age >18 years) who were diagnosed with either Crohn’s disease (CD) or ulcerative colitis (UC). We investigated the prevalence of ED in IBD patients compared to patients with no IBD. Also, we compared the prevalence of ED between IBD patients with and without biologics therapy. Odds ratios with 95% conﬁdence intervals were calculated to evaluate the risk of ED.

Results: In this male-only cohort, we identified 100,020 patients with CD and 86,340 patients with UC, of whom 7,060 (7.06%) and 7,430 (8.61%) developed ED, respectively compared to 2.89% in individuals without IBD, p< 0.0001 to all. Both CD [OR: 2.54; 95% CI: 2.48-2.61] and UC [OR: 3.16; 95%CI: 3.08-3.23] patients had a significant higher risk of ED compared to patients without IBD. 20,040 (20.0%) patients with CD and 10,980 (12.7%) patients with UC received biologics therapy. The biologics-treated cohort was not significantly associated with a lower risk of developing ED in both CD [OR: 1.02; 95%CI: 0.96-1.09] and UC [OR: 0.99; 95%CI: 0.92-1.07], respectively (Figure 1).

Discussion: In this large retrospective study, we found that the prevalence of ED in patients with IBD was significantly higher than the general population. Overall, treatment with biologics was not associated with a significant decline in ED among IBD patients. These findings suggest that ED among patients with IBD may be driven by a different pathology besides chronic inflammation. Further studies are needed to determine the etiology behind ED among IBD patients.

Figure: Logistic Regression of Erectile Dysfunction Risk in IBD, IBD; inflammatory bowel disease. Immunomodulators included Azathioprine, Methotrexate and Mercaptopurine. Other biologics included Natalizumab, Ustekinumab and Vedolizumab. TNF-a Blockers; tumor necrosis factor-alpha blocker.

Variable	Patients with ED				No ED
Variable	With IBD		Without IBD		No ED
N	12,780	%	903,480	%	30532290	%
Age 18 - 64	5,760	45.1%	434,850	48.1%	21,038,710	68.9%
Age >65	7,070	55.3%	472,220	52.3%	9,126,770	29.9%
Caucasian	10,640	83.3%	663,680	73.5%	16,599,190	54.4%
Smoker	2,810	22.0%	151,670	16.8%	1,791,870	5.9%
Alcohol abuse	980	7.7%	52,640	5.8%	674,360	2.2%
T2DM	4,150	32.5%	270,010	29.9%	2,627,640	8.6%
Hyperlipidemia	9,350	73.2%	639,150	70.7%	5,077,870	16.6%
HTN	4,330	33.9%	255,660	28.3%	1,366,290	4.5%
CAD	3,780	29.6%	196,350	21.7%	2,027,450	6.6%
Depressive disorder	4,590	35.9%	213,260	23.6%	2,010,190	6.6%
Colectomy	3,190	25.0%	89,640	9.9%	488,020	1.6%
Small intestinal repair/resection	1,880	14.7%	16,560	1.8%	473,250	1.6%
PDE5 inhibitor use	4,620	36.2%	337,800	37.4%	342,420	1.1%

Table: Demographics of patients with IBD and ED. IBD; inflammatory bowel disease, ED; erectile dysfunction, T2DM; type 2 diabetes mellitus, HTN; essential hypertension, CAD; coronary artery disease, PDE5; phosphodiesterase type 5 inhibitor.

Disclosures:

Ahmed Eltelbany indicated no relevant financial relationships.

Khaled Alsabbagh Alchirazi indicated no relevant financial relationships.

Osama Hamid indicated no relevant financial relationships.

Rama Nanah 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.

Ahmed Eltelbany, MD, MPH¹, Khaled Alsabbagh Alchirazi, MD¹, Osama Hamid, MD, MRCPI¹, Rama Nanah, MD¹, Abdul Mohammed, MD¹, Miguel Regueiro, MD². A0386 - Impact of Biologics Therapy on the Prevalence of Erectile Dysfunction Among Patients With Inflammatory Bowel Disease: A Nationwide Population-Based Study, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.