Patients with Crohn disease—, especially women—are at higher risk of developing multiple extraintestinal manifestations (EIMs), according to research conducted at the University of Maryland.

Furthermore, they found that patients with ocular EIMs are more likely to have another EIM.

Madeline Alia Alizadeh, MD, and Raymond Cross, MD, of University of Maryland School of Medicine, Baltimore, Maryland; and Kiran Motwani, MD, of University of Maryland Medical System, spearheaded this research to establish association of EIMs with IBD type, gender and age. “Understanding how individual EIMs relate to one another can be used to better identify patients at risk of developing future EIMs and may help with risk stratification when choosing treatments,” they said.

To better characterize which patients may be at higher risk of developing multiple EIMs, they conducted a retrospective review of patients enrolled in the Study of Prospective Adult Research Cohort with IBD (SPARC IBD) registry. They analyzed the demographics, clinical data, and patient-reported outcomes of the 1202 total patients enrolled. Data regarding EIMs such as IBD-associated arthropathy, ocular complications including uveitis/iritis, primary sclerosing cholangitis, erythema nodosum, pyoderma gangrenosum, and thrombotic complications were collected.

The results showed 347 patients with at least 1 EIM, compared to 855 patients without any EIMs. Of the 347 patients, 284 had 1 EIM, 54 had 2 EIMs, and 9 had 3 EIMs. Patients with Crohn disease and women were more likely to have 2 or more EIMs (p-value = 0.00517 and 0.000285, respectively). Patients with ocular manifestations were likeliest to have at least 2 EIMs (with 27/37 or 73.0% having multiple), while those with pyoderma gangrenosum and IBD associated arthritis were least likely to have additional EIMs (p-value = 0.000500).

Most patients with 3 EIMs had IBD-associated arthritis and/or erythema nodosum (88% having each), while only 1 patient (11%) with 3 EIMs had PSC (p-value = 0.00161).

The results suggest that patients with Crohn disease, particularly women, are more likely to develop multiple EIMs. Such profiling could help experts identify patients at risk and proactively support and treat them, the authors noted.

—Priyam Vora

Reference:
Alizadeh M, Motwani K and Cross R. Presentation number: P060. Predictors of developing multiple extra-intestinal manifestations of inflammatory bowel disease. Presented at: Crohn’s and Colitis Congress 2023; January 20, 2023. Denver, Colorado