ECCO Guidelines on Extraintestinal Manifestations in Inflammatory Bowel Disease

Gordon, Hannah; Burisch, Johan; Ellul, Pierre; Karmiris, Konstantinos; Katsanos, Konstantinos; Allocca, Mariangela; Bamias, Giorgos; Acosta, Manuel Barreiro‐de; Braithwaite, Tasanee; Greuter, Thomas; Harwood, Catherine A.; Juillerat, Pascal; Ortega, Triana Lobatón; Müller‐Ladner, Ulf; Noor, Nurulamin M; Pellino, Gianluca; Savarino, Edoardo; Schramm, Christoph; Soriano, Alessandra; Stein, Jürgen M.; Uzzan, Mathieu; Rheenen, Patrick F. van; Vavricka, Stephan R.; Vecchi, Maurizio; Zuily, Stéphane; Kucharzik, Torsten

doi:10.1093/ecco-jcc/jjad108

Cited by 45 publications

(51 citation statements)

References 471 publications

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“…Публикации ряда авторов и данные Северо-Западного регистра пациентов с ВЗК свидетельствуют о том, что ВКП могут отмечаться у 50-60% больных [50,51]. Бóльшая частота ВКП отмечается при БК [52,53], у пациентов женского пола [54,55], курильщиков [60] и при большей продолжительности заболевания [60]. По данным исследователей группы SIBDCS, у 26% пациентов ВКП будут проявлять себя до диагностирования ВЗК (среднее время -5 мес до постановки диагноза ВЗК), и в 74% случаев первые симптомы проявятся после верификации ВЗК (медиана 92 мес) [56].…”

Section: внекишечные проявленияunclassified

“…В процесс могут вовлекаться как осевые, так и периферические суставы. Среди аксиальных воспалительных артропатий принято различать анкилозирующий спондилит, характеризующийся воспалительной болью в спине и, при проведении магнитно-резонансной томографии, наличием признаков сакроилеита/спондилита (частота выявления при ВЗК составляет 1-12%), и изолированный сакроилеит (частота выявления при ВЗК -16-46%) [57,60].…”

Section: внекишечные проявленияunclassified

“…В настоящее время нет никаких доказательств ассоциации применения нестероидных противовоспалительных препаратов (НПВП) и обострения ЯК, но потенциально существует взаимосвязь с обострением при БК [60]. Тем не менее решение о применении НПВП принимается в каждом отдельном случае, а препаратами предпочтения являются селективные ингибиторы циклооксигеназы-2 [60].…”

Section: внекишечные проявленияunclassified

“…Гнойный гидраденит имеет распространенность до 23% у пациентов с ВЗК (0,4-15,0% при БК и 0,1-6,1% -при ЯК) по сравнению с 0,1-4,0% в общей популяции [59,60]. Примечательно, что у пациентов с гнойным гидраденитом и БК чаще выявлялось распространенное поражение -илеоколит (отношение шансов -ОШ 8,3, 95% доверительный интервал -ДИ 2,9-23,8; p<0,01) и перианальное поражение (ОШ 2,9, 95% ДИ 1,19-6,8; p<0,01) [60].…”

Section: внекишечные проявленияunclassified

See 3 more Smart Citations

Inflammatory bowel diseases: Transformation of representations. A review

Maev,

Bakulin,

Skalinskaya

et al. 2023

Terapevticheskii arkhiv

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The global burden of inflammatory bowel disease (IBD) is currently significant and continues to grow due to the increasing prevalence of ulcerative colitis (UC) and Crohn's disease (CD), the increasing costs of diagnosis and treatment, and the high level of disability in patients with this disease. Categories, which leads to the search for risk factors and predictors of aggressive course and extraintestinal manifestations. According to the latest data, the prevalence of UC in Russia is 16.6 per 100 000 population, the annual registered increase is 11.3%; the prevalence of CD is 5.6 per 100 000 population, and the increase is 13.7%. In the Russian population of patients with IBD, the average age of disease onset is 35.3 years for UC and 31.2 years for CD. Moreover, in 89.3% of patients with UC, it took at least 2 years to verify the diagnosis, and in CD, within 2 years from the onset of clinical symptoms, the diagnosis was established in only 72.6% of patients. One of the dominant characteristics of IBD is its multisystem nature, which leads to the development of extraintestinal manifestations (ECM), which can be observed in 50–60% of patients, while up to 25% of patients with IBD have several EMC and the most common variants are joint lesions. A higher frequency of extraintestinal manifestations is observed in CD (up to 45% of patients), in female patients, in smokers and with a longer duration of the disease. To predict clinical remission, the level of fecal calprotectin and CRP, the need for glucocorticosteroids are important, to predict endoscopic remission – the level of fecal calprotectin, and to predict histological remission, an endoscopic Schroeder index value of ≤1 is important. The absolute risk of developing colorectal cancer in IBD remains relatively low, ranging from 1.1 to 5.4% after 20 years of disease. The main risk factors for IBD are total intestinal damage, high inflammatory activity, the stricturing phenotype of CD and the presence of primary sclerosing cholangitis.

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Section: внекишечные проявленияunclassified

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Inflammatory bowel diseases: Transformation of representations. A review

Maev,

Bakulin,

Skalinskaya

et al. 2023

Terapevticheskii arkhiv

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“…Identified genetic risk loci 1;2 may -in combination with environmental factors, such as diet, smoking, exercise, and exposure to infectious agents-be implicated in disease development 3 through multiple mechanisms, including epigenetic modifications, alterations in the gut microbiota, and immune dysregulation 4 . To complicate the aetiological understanding of IBD further, between 6-50% of patients develop extra-intestinal manifestations (EIMs), including erythema nodosum, uveitis, primary sclerosing cholangitis, and autoimmune hepatitis 5 , or immune-mediated inflammatory diseases (IMIDs), including psoriasis and ankylosing spondylitis, which may share common inflammatory pathways, genetic associations 6 , and response to anti-inflammatory therapies including those targeting TNF, IL12/23 and JAK inhibition. Emerging evidence also suggests that neuropsychiatric diseases 7 and cardiovascular diseases occur with increased frequency in IBD 8 , and additional diseases may occur either due to chronic inflammation, altered immunity and/or treatment with corticosteroids and immunosuppression 9 .…”

Section: Introductionmentioning

confidence: 99%

Inflammatory bowel disease and risk of more than 1500 comorbidities: A disease-wide pre- and post-diagnostic phenomic association study

Ebert,

Elmahdi,

Poulsen

et al. 2024

Preprint

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Background and Aims:Inflammatory bowel disease (IBD), including Crohn's disease (CD) and ulcerative colitis (UC), is associated with various extra-intestinal manifestations. Identifying comorbidities in IBD and timing of their development provides valuable insight into mechanisms underlying IBD.Methods:We conducted a population- and disease-wide phenomic association study in IBD, using >6 million ICD-10 coded healthcare contacts from 10 years before and up-to 17 years after IBD diagnosis to investigate associations with 1583 comorbidities. To explore diseases with potential aetiological significance, we compared strength of association with co-morbidities in the pre-diagnostic with the post-diagnostic period. To correct for multiple testing, we adjust the significance threshold with the Bonferroni correction (p-value <7.90×10-6).Results:We identified 312 statistically significant associations with 125 of these appearing before diagnosis. Risk of immune-mediated diseases and extra-intestinal manifestations is increased up to 10 years prior to IBD diagnosis (e.g., enteropathic arthropathies: RRCD: 3.57, 95% CI: 2.65-4.78; RRUC: 1.8, 95% CI: 1.38-2.32). As with hepatic and pancreatic disorders (e.g., acute pancreatitis: RRCD: 1.83, 95% CI: 1.30-2.53; RRUC: 2.27, 95% CI: 1.84-2.79). Risk of cardiometabolic diseases and neuropsychological disorders was increased both pre- and post-diagnostically. Potential sequelae of treatment, such as osteoporosis (HRCD: 2.56, 95% CI: 2.30-2.86; HRUC: 1.92, 95% CI: 1.79-2.07) were primarily seen post-diagnostically. Infectious mononucleosis (RR: 1.87, 95% CI: 1.37-2.52) was significantly associated with the pre- compared to the post-diagnostic period for CD.Conclusion:Findings demonstrate that IBD is a multisystemic disease, particularly manifesting with metabolic, immune, and neuropsychological disorders, up-to 10 years prior to diagnosis. Diseases of aetiological interest identified warrant further investigation.

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Epidemiological data and medical care situation of patients with chronic inflammatory diseases in Germany

Riemekasten,

Schmelz,

Schäkel

et al. 2023

Z Rheumatol

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Zusammenfassung Hintergrund Chronisch entzündliche Erkrankungen („immune-mediated inflammatory diseases“ [IMID]) können aufgrund klinischer Gemeinsamkeiten überlappen oder gleichzeitig auftreten. Die daraus resultierende Inanspruchnahme von Versorgungsstrukturen wurde bisher nicht fachübergreifend untersucht, ist aber für eine optimierte Behandlung der Patienten mit IMID potenziell von Bedeutung. Ziel der Arbeit Analyse epidemiologischer Daten einschließlich Inanspruchnahme von Versorgungsleistungen bei Patienten mit ausgewählten IMID: Psoriasis, Psoriasisarthritis (PsA), rheumatoide Arthritis (RA), Spondylitis ankylosans, Colitis ulcerosa, Morbus Crohn und Kollagenosen. Material und Methoden In einer retrospektiven Querschnittanalyse, basierend auf Abrechnungsdaten der gesetzlichen Krankenversicherung (GKV) mit einer Stichprobe von ca. 4 Mio. Versicherten, wurden die Prävalenz o. g. IMID und die Häufigkeit von IMID-Kombinationen anhand dokumentierter Diagnosen (ICD-10 GM) analysiert. Die Häufigkeit von Hospitalisierungen und Inanspruchnahmen ambulanter Arztkontakte wurde in vordefinierten Fachdisziplinen (Allgemeinmedizin, Dermatologie, Gastroenterologie, Rheumatologie) erfasst und mit einer alters- und geschlechtsadjustierten Referenzpopulation verglichen. Ergebnisse Insgesamt wiesen 188.440 Patienten mindestens eine der analysierten IMID-Diagnosen auf (4,7 %), mit einem Altersgipfel von 61 bis 70Jahren. Die höchste Prävalenz wurde für die Psoriasis (1,85 %), gefolgt von der rheumatoiden Arthritis (1,38 %) gesehen. Kombinationen mit mindestens einer weiteren IMID kamen insgesamt relativ häufig vor (29 %), wobei dies bei Patienten mit Psoriasisarthritis am häufigsten zu verzeichnen war (82,9 %, wobei hiervon 68,2 % Psoriasis), gefolgt von Spondylitis ankylosans (27,5 %) und Morbus Crohn (21,6 %). Patienten mit IMID wurden im Vergleich zur Referenzpopulation häufiger hospitalisiert und wiesen häufigere Inanspruchnahmen der betrachteten ambulanten Fachdisziplinen auf. Diskussion Die Studienergebnisse beschreiben, dass IMIDs gehäuft koexistieren und die Patienten Versorgungsstrukturen verschiedener Fachgebiete vergleichsweise mehr in Anspruch nehmen. Ein multidisziplinärer Ansatz könnte die Effizienz der Versorgung steigern, eine Evaluierung steht aus.

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ECCO Guidelines on Extraintestinal Manifestations in Inflammatory Bowel Disease

Cited by 45 publications

References 471 publications

Inflammatory bowel diseases: Transformation of representations. A review

Inflammatory bowel diseases: Transformation of representations. A review

Inflammatory bowel disease and risk of more than 1500 comorbidities: A disease-wide pre- and post-diagnostic phenomic association study

Epidemiological data and medical care situation of patients with chronic inflammatory diseases in Germany

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