A0366 - The Prevalence of Vasculitis Is Increased in Inflammatory Bowel Disease, but Decreased After Anti-TNF Treatment: 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, Somtochukwu Onwuzo, MD², Miguel Regueiro, MD³
¹Cleveland Clinic, Cleveland, OH; ²Cleveland Clinic Foundation, Cleveland, OH; ³Cleveland Clinic Main Campus, Cleveland, OH

Introduction: Extraintestinal manifestations (EIM) are seen in 6% to 25% of patients with inflammatory bowel disease (IBD). Vasculitis is a rare rheumatologic manifestation of IBD and not properly described in the literature EIMs are more often associated with active colonic inflammation. Our study describes the effect of anti-TNF therapy on the prevalence of vasculitis in IBD patients.

Methods: We used a multi-institutional 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) with a concomitant diagnosis of IBD and vasculitis between 1999 to present. We compared the prevalence of vasculitis in patients with and without IBD. We also assessed the prevalence of vasculitis in IBD patients with and without anti-TNF therapy.

Results: Of the 70, 301,380 individuals in the database, we identified 249,300 (0.35%) patients with CD and 208,880 (0.30%) patients with UC, of whom 40,840 (16.4%) and 20,200 (10%) patients received anti-TNFs, respectively. The prevalence of Vasculitis was 7.6% and 8.9% for CD and UC, respectively, compared to 0.9% in individuals without IBD (p< 0.0001). The prevalence of vasculitis was significantly lower in anti-TNF treated CD patients (4.5%) compared to those who did not receive anti-TNF therapy (8.2%). Similarly, anti-TNF-treated UC patients were significantly less likely to have vasculitis (5.9%) compared to UC patients who did not receive anti-TNF therapy (9.2%) (p < 0.0001).

Discussion: In our large cohort of IBD patients, anti-TNF medications appear to be associated with a decreased prevalence of vasculitis. Further studies are needed to ascertain the anti-inflammatory properties of anti-TNF medications on vascular endothelium.

Figure: Figure 1: The prevalence of vasculitis in patients with inflammatory bowel disease with and without anti-TNF therapy.
Anti-TNF; anti tumor necrosis factor.

Anti-TNF therapy	Vasculitis
Anti-TNF therapy	Crohn's Disease, 1840 (%)	Ulcerative Colitis, 1190 (%)
Infliximab	650 (35%)	480 (40%)
Adalimumab	660 (36%)	390 (33%)
Certolizumab	60 (3%)	10 (1%)
Golimumab	10 (1%)	20 (2%)

Table: Table 1: Anti-TNF characteristics of inflammatory bowel disease individuals with vasculitis.

Disclosures:

Khaled Alsabbagh Alchirazi indicated no relevant financial relationships.

Ahmed Eltelbany indicated no relevant financial relationships.

Abdul Mohammed indicated no relevant financial relationships.

Somtochukwu Onwuzo 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, Somtochukwu Onwuzo, MD², Miguel Regueiro, MD³. A0366 - The Prevalence of Vasculitis Is Increased in Inflammatory Bowel Disease, but Decreased After Anti-TNF Treatment: A Population-Based Study, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.