Association between inflammatory bowel disease and spondyloarthritis: findings from a nationwide study in SwedenShow others and affiliations
2022 (English)In: Journal of Crohn's & Colitis, ISSN 1873-9946, E-ISSN 1876-4479, Vol. 16, no 1, p. 1540-1550Article in journal (Refereed) Published
Abstract [en]
BACKGROUND AND AIMS: Inflammatory bowel disease (IBD) has been associated with spondyloarthritis (SpA), but population-based estimates are scarce. Here we compare the occurrence of SpA before and after a diagnosis of IBD to the general population, overall and by IBD subtype and age.
METHODS: We used a nationwide register-based cohort study of 39,203 patients diagnosed with IBD during 2006-2016, identified from Swedish registers and gastrointestinal biopsy data, and 390,490 matched reference individuals from the general population. Conditional logistic regression models were used to estimate odds ratios (ORs) for a prior (prevalent) SpA diagnosis and conditional Cox regression to calculate hazard ratios (HRs) for a subsequent (incident) SpA diagnosis in IBD patients.
RESULTS: IBD patients were more likely to have prevalent SpA at IBD diagnosis (2.5%) compared to reference individuals (0.7%) with an OR of 3.48 (95%CI:3.23-3.75). They also more often received an incident diagnosis of SpA; during 23,341,934 person-years of follow-up in IBD patients, there were 1,030 SpA events (5.0/1,000 person-years) compared to 1,524 SpA events in the reference group (0.72/1,000 person-years), corresponding to an HR of 7.15 (95%CI:6.60-7.75). In subgroup analyses, associations were most pronounced among patients with Crohn's disease [(OR=5.20; 95%CI:4.59-5.89), and (HR=10.55; 95%CI:9.16-12.15)] and paediatric onset IBD [(OR=3.63; 95%CI:2.35-5.59) and (HR=15.03; 95%CI:11.01-20.53)].
CONCLUSION: IBD patients more frequently experience SpA both before and after the diagnosis of IBD compared to the general population, supporting evidence of a shared pathophysiology. The variation in SpA comorbidity across IBD subtypes and age-groups, calls for targeted approaches to facilitate timely diagnosis and intervention.
Place, publisher, year, edition, pages
Oxford University Press, 2022. Vol. 16, no 1, p. 1540-1550
Keywords [en]
epidemiology, inflammatory bowel diseases, population-based study, spondyloarthritis
National Category
Gastroenterology and Hepatology
Identifiers
URN: urn:nbn:se:oru:diva-98862DOI: 10.1093/ecco-jcc/jjac065ISI: 000813274200001PubMedID: 35512691Scopus ID: 2-s2.0-85141889167OAI: oai:DiVA.org:oru-98862DiVA, id: diva2:1656438
Funder
European Commission, 754285Swedish Research Council, 2020-02021
Note
Funding agency:
Orebro University Hospital Research Foundation OLL-936004 OLL-890291 OLL-790011 OLL-723021
2022-05-062022-05-062025-02-11Bibliographically approved
In thesis