A0364 - The Epidemiology of Inflammatory Bowel Disease in Eosinophilic Esophagitis in the United States: Results From a Population-Based National 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, Abdul Mohammed, MD¹, Ahmed Eltelbany, MD, MPH¹, Osama Abu-Shawer, MD, MS¹, Prashanthi Thota, MD², Miguel Regueiro, MD³
¹Cleveland Clinic, Cleveland, OH; ²Cleveland Clinic, Cleveland, OH; ³Cleveland Clinic Main Campus, Cleveland, OH

Introduction: Eosinophilic esophagitis (EoE) and inflammatory bowel disease (IBD) are immune-mediated diseases with potential pathogenesis and epidemiology intersections. We aim to investigate the relationship between EoE and IBD and describe the epidemiology of individuals with EoE with co-existent IBD in the United States (US).

Methods: We queried a multi-instituitional database (Explorys Inc, Cleveland, OH), an aggregate of electronic health record data from 26 major integrated US healthcare systems. We identified an aggregated patient cohort of eligible patients with EoE and concomitant IBD based on Systematized Nomenclature of Medicine - Clinical Terms (SNOMED-CT) from 1999 to present. we calculated the prevalence of IBD in EoE and among different patient group.

Results: Of the 70,383,890 individuals in the database, we identified 41,670 patients with EoE, 249,420 patients with Crohn’s disease (CD), and 208,990 patients with Ulcerative colitis (UC). Patients with EoE had concomitant CD, with an overall prevalence of CD in EoE being 2%, with an odds ratio (OR) of 5.80 (95% CI: 5.42-6.21, p < 0.0001), compared to individuals without EoE. Patients with EoE also had concomitant UC, with an overall prevalence of UC in EoE being 1.6%, with an odds ratio (OR) of 5.42 (95% CI: 5.02-5.85, p < 0.0001), compared to individuals without EoE (figure 1). The prevalence of CD in EoE was higher in males vs. females (58.3% vs. 41.7%), Caucasians vs. non-Caucasians (78.6% vs. 21.4%), and in patients 18-65-year-old vs. >65 years old (88.1% vs. 11.9%), P < 0.0001 to all. Similarly, the prevalence of UC in EoE was higher in males vs. females (55% v.s 45%), Caucasians v.s non-Caucasians (80.3% v.s 19.,7%), and in patients 18-65 years old vs. >65 years old (80.3% vs. 19.7%), P < 0.0001 to all (table 1).

Discussion: In one of the first large population-based studies on the epidemiology of IBD and EoE, we found that the prevalence of CD in EoE is 2% and UC in EoE 1.6% which emphasizes the importance of awareness among the gastroenterologists regarding the coexistence of EoE and IBD. Further studies are needed to understand the underlying mechanism of the association between these conditions.

Figure: Figure 1: Prevalence of EoE, CD, UC, CD in EoE and UC in EoE overall.
EoE; Eosinophilic Esophagitis, CD; crohn's disease, UC; ulcerative colitis.

CD in EoE
Variables	OR	95% CI	P Value
Age ( >65 vs 18-65)	54.76	40.76-73.57	< 0.0001
Sex (Male vs Female)	1.96	1.61-2.38	< 0.0001
Race (Caucasian vs non-Caucasian)	13.44	10.65-16.97	< 0.0001
UC in EoE
Variables	OR	95% CI	P Value
Age ( >65 vs 18-65)	16.62	12.67-21.80	< 0.0001
Sex (Male vs Female)	1.36	1.09-1.69	< 0.0001
Race (Caucasian vs non-Caucasian)	16.62	12.67-21.80	< 0.0001

Table: Table 1: Gender, Race and Age based sub-groups distribution of CD in EoE and UC in EoE. Univariate analysis used to calculate OR. OR; odds ratio. CI; confidence interval, CD; Crohn's disease, UC; ulcerative colitis, EoE; eosinophilic esophagitis.

Disclosures:

Khaled Alsabbagh Alchirazi indicated no relevant financial relationships.

Abdul Mohammed indicated no relevant financial relationships.

Ahmed Eltelbany indicated no relevant financial relationships.

Osama Abu-Shawer indicated no relevant financial relationships.

Prashanthi Thota 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, Abdul Mohammed, MD¹, Ahmed Eltelbany, MD, MPH¹, Osama Abu-Shawer, MD, MS¹, Prashanthi Thota, MD², Miguel Regueiro, MD³. A0364 - The Epidemiology of Inflammatory Bowel Disease in Eosinophilic Esophagitis in the United States: Results From a Population-Based National Study, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.