Katherine Shepherd, MD, Ethan M.. Cohen, MD, Joshua Kirkpatrick, MD, Alyssa Lorenze, MD, Zach Kovach, MD, Jennifer Hadam-Veverka, MD West Virginia University, Morgantown, WV
Introduction: Hidradenitis suppurativa (HS) is an inflammatory skin condition defined by debilitating skin lesions that form in areas with high volumes of apocrine glands, with the most common areas being the axillary, inguinal, and anogenital regions. Inflammatory bowel disease (IBD), consisting of Ulcerative colitis (UC) and Crohn’s disease (CD), is a well-known inflammatory disorder of the bowel with well-documented extraintestinal manifestations. Studies have proposed a link between HS and IBD due to the inflammatory nature of both conditions, and while TNF-alpha inhibitors are an effective treatment of both diseases, data on the outcomes of IBD in this population is limited. We aim to perform the largest retrospective cohort study to date in this population, looking at the IBD outcomes of concurrent HS and IBD.
Methods: We conducted a large retrospective cohort study using the TriNetX platform. The intervention group included adult patients ( >18 years old) with UC or CD and HS, and the control group included adult patients diagnosed with UC or CD. Propensity score matching (PSM) was performed for age, gender, ethnicity, nicotine use, body mass index, and IBD type. Outcomes analyzed included IBD intestinal complications, extraintestinal manifestations, medications, and associated comorbidities.
Results: The intervention cohort consisted of 3,128 patients with IBD and HS and the control cohort had 250,415 patients with IBD only. After 1:1 PSM, 2,959 patients were included in each cohort. The intervention cohort was found to have increased fistula formation (OR 2.582, p< 0.001) and decreased bowel obstruction (OR 0.803, p=0.020). The intervention cohort also had increased incidence of spondyloarthropathy (OR 1.456, p< 0.001) and arthritis (OR 1.505, p< 0.001), but no difference was seen in ocular manifestations (OR 1.381, p >0.05). A statistically significant difference was noted between the intervention group and the control group with increased rates of TNF-alpha medications (1.239, p< 0.001) as expected and other biologics (OR 1.452, p< 0.001). No significant difference was found between cohorts for the rate of cholangiocarcinoma and PSC.
Discussion: IBD and HS are two inflammatory conditions that can occur independently or concurrently. When diagnosed concurrently, our data shows that there is an increased risk of both intestinal complications and extraintestinal manifestations, and there is a significant difference in medications compared to patients without a diagnosis of HS.
Note: The table for this abstract can be viewed in the ePoster Gallery section of the ACG 2024 ePoster Site or in The American Journal of Gastroenterology's abstract supplement issue, both of which will be available starting October 27, 2024.
Disclosures:
Katherine Shepherd indicated no relevant financial relationships.
Ethan Cohen indicated no relevant financial relationships.
Joshua Kirkpatrick indicated no relevant financial relationships.
Alyssa Lorenze indicated no relevant financial relationships.
Zach Kovach indicated no relevant financial relationships.
