Prevalence of and factors associated with extraintestinal manifestations and their remission in inflammatory bowel disease: the EXTRA prospective study from the GETAID
Résumé
Abstract Background and aims: Extraintestinal manifestations (EIM) of inflammatory bowel disease (IBD) are challenging clinical situation. No prospective study assessed remission risk factors for EIMs. Study aimed to prospectively investigate the epidemiology, risk factors for EIM occurrence and EIM remission in a large IBD cohort. Methods: We conducted a cross-sectional study in 30 French referral centers. Between May to June 2021, all consecutive patients attending to hospital appointment were systematically invited to fill out a questionnaire. Results: A total of 1971 consecutive patients with IBD were analyzed. There were 1056 women (53.8%), and the median age of patients was 41 years [31; 54]. The median disease duration was 11 years [1; 18]. Overall, 544 (27.6%) had at least one EIM. In 20.2% of case, patient had multiple EIMs. The most frequent EIMs were rheumatological (19%) and dermatological (10%) manifestations. Immunosuppressant treatment (OR=2.56; p<0.001) was a risk factor for EIM, while the Montreal A3 classification (OR=0.61, p=0.023) and male gender (OR=0.61, p<0.001) were associated with a lower risk for EIM occurrence. IBD current clinical remission (OR=2.42; p<0.001) and smoking cessation (OR=2.98; p<0.001) were associated factors for EIM remission. Conversely, age at IBD diagnosis (OR=0.98; p<0.018) was associated with a lower risk of EIM remission. Conclusion: One quarter of patients had at least one EIM. Beyond factors associated with the presence of EIMs, patients with IBD current clinical remission and smoking cessation are more likely to achieve EIM remission, while increasing age at IBD diagnosis is associated with decreased chance of remission.
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