P2659 - Statin Use Decreases Odds of IBD-related Surgery Among Patients With Moderate-to-Severe Inflammatory Bowel Disease

Monday, October 28, 2024

10:30 AM – 4:00 PM ET

Location: Exhibit Hall E

Has Audio

Presenting Author(s)

JC

Jennifer Claytor, MD, MS

Icahn School of Medicine at Mount Sinai
New York, NY

Jennifer Claytor, MD, MS, Palak Rajauria, BA, MS, Jean-Frédéric Colombel, MD, Ryan C. Ungaro, MD
Icahn School of Medicine at Mount Sinai, New York, NY

Introduction: Conflicting data suggest that statins may reduce incidence of inflammatory bowel disease (IBD). The goal of this study was to investigate any impact of statins on disease progression in moderate-to-severe IBD.

Methods: We performed a single-center, retrospective cohort study of all patients with IBD with at least biannual outpatient visits since 1983. Via Mount Sinai Data Warehouse, we collected patient demographics (Table 1), start and stop dates of IBD-related and cardiovascular medications, and ICD-9 and -10 codes designating IBD-primary hospitalizations and surgeries. We excluded patients with prior cardiac disease or under 1 year of follow-up. We restricted our analysis to patients with moderate-to-severe IBD, as proxied by previous use of a biologic and/or an immunomodulator, to limit unmeasured confounding. Chi2 tests tested differences between categorical variables, and Kruskal-Wallis tests, continuous variables (p-values < 0.05). All factors with p-value < 0.10 on univariate regression were included in a multivariable regression analysis, assessing the odds of 1) IBD-related surgery or 2) IBD-related hospitalization (OR, 95%CI, p-values).

Results: 2421 patients had moderate-to-severe IBD with longitudinal outpatient follow-up and available data for cardiac risk stratification (Table 1). Of these, 375 used statins, and 2046 did not; 321 took statins at time of biologic/IMM, 52 started within 1 year, and 2 started later. On univariate analysis, a UC diagnosis (OR 1.74, 1.21-2.49, p=0.003), statin use (OR 0.52, 0.32-0.83, p=0.008), requiring an IBD medication class-switch (OR 2.51, 1.8-3.5, p=0.000) and being overweight (OR 0.63, 0.47-0.84, p=0.001) impacted odds of surgery. Adjusting for smoking, BMI, and type of IBD, statin use predicted a lower odds of requiring surgery (OR 0.56, 0.34-0.93, p=0.02), but not of hospitalization (OR 0.87, p=0.237).

Discussion: In our experience, patients with moderate-severe IBD using statins had lower odds of IBD-related surgery, independent of age, sex, race, smoking, BMI, UC status, LDL cholesterol, and baseline cardiovascular risk. Further prospective and translational studies are needed to elucidate the mechanisms and disease-modifying potential of statins among patients moderate-to-severe IBD.

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:

Jennifer Claytor indicated no relevant financial relationships.

Palak Rajauria indicated no relevant financial relationships.

Jean-Frédéric Colombel: AbbVie – Consultant, Grant/Research Support. Allergan – Consultant. Amgen – Consultant. AnaptysBio – Consultant. Arena Pharmaceuticals – Consultant. Boehringer Ingelheim – Consultant. Bristol Myers Squib – Consultant, Grant/Research Support. Celgene – Consultant. Celltrion – Consultant. Eli Lilly – Consultant. Enterome – Consultant. Ferring – Consultant. Galmed Research – Consultant. Genentech – Consultant. Genfit – Stock-publicly held company(excluding mutual/index funds). Glaxo Smith Kline – Consultant. Immunic – Consultant. Intestinal Biotech Development – Stock-publicly held company(excluding mutual/index funds). Iterative Scopes – Consultant. Janssen – Consultant, Grant/Research Support. Johnson & Johnson – Consultant, Grant/Research Support. Kaleido Biosciences – Consultant. Landos – Consultant. MedImmune – Consultant. Merck – Consultant. Microba Life Science – Consultant. Novartis – Consultant. Otsuka Pharmaceutical – Consultant. Pfizer – Consultant. PPM Services – Consultant. Protagonist – Consultant. Sanofi – Consultant. Second Genome – Consultant. Seres – Consultant. Shire – Consultant. Takeda – Consultant, Grant/Research Support. Theradiag – Consultant. TiGenix – Consultant. Vifor – Consultant.

Ryan C. Ungaro: AbbVie – Advisory Committee/Board Member, Grant/Research Support. Boehringer Ingelheim – Grant/Research Support. Bristol Myers Squibb – Advisory Committee/Board Member. Celltrion – Advisory Committee/Board Member, Consultant. Eli Lilly – Grant/Research Support. Inotrem – Advisory Committee/Board Member, Consultant. Janssen – Advisory Committee/Board Member. Pfizer – Advisory Committee/Board Member, Grant/Research Support. Prometheus Labratories – Grant/Research Support. Roivant – Advisory Committee/Board Member, Consultant. Takeda – Advisory Committee/Board Member.

Jennifer Claytor, MD, MS, Palak Rajauria, BA, MS, Jean-Frédéric Colombel, MD, Ryan C. Ungaro, MD. P2659 - Statin Use Decreases Odds of IBD-related Surgery Among Patients With Moderate-to-Severe Inflammatory Bowel Disease, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.