Association Between Inflammatory Bowel Disease and Spondyloarthritis : Findings from a Nationwide Study in Sweden
(2022) In Journal of Crohn's and Colitis 16(10). p.1540-1550- Abstract
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 with 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... (More)
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 with 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 with 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 1030 SpA events [5.0/1000 person-years] compared with 1524 SpA events in the reference group [0.72/1000 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]). Conclusions: IBD patients more frequently experience SpA both before and after the diagnosis of IBD compared with 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.
(Less)
- author
- publishing date
- 2022-10-01
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- epidemiology, Inflammatory bowel diseases, population-based study, spondyloarthritis
- in
- Journal of Crohn's and Colitis
- volume
- 16
- issue
- 10
- pages
- 11 pages
- publisher
- Oxford University Press
- external identifiers
-
- pmid:35512691
- scopus:85141889167
- ISSN
- 1873-9946
- DOI
- 10.1093/ecco-jcc/jjac065
- language
- English
- LU publication?
- no
- additional info
- Publisher Copyright: © 2022 The Author(s). Published by Oxford University Press on behalf of European Crohn's and Colitis Organisation.
- id
- dce37d33-2f6c-4114-8426-f024459a3320
- date added to LUP
- 2023-06-29 15:56:00
- date last changed
- 2024-04-20 00:11:49
@article{dce37d33-2f6c-4114-8426-f024459a3320,
abstract = {{<p>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 with 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 with 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 1030 SpA events [5.0/1000 person-years] compared with 1524 SpA events in the reference group [0.72/1000 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]). Conclusions: IBD patients more frequently experience SpA both before and after the diagnosis of IBD compared with 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.</p>}},
author = {{Shrestha, Sarita and Brand, Judith S. and Järås, Jacob and Schoultz, Ida and Montgomery, Scott and Askling, Johan and Ludvigsson, Jonas F. and Olen, Ola and Halfvarson, Jonas and Olsson, Malin and Hjortswang, Henrik and Myrelid, Par and Bengtsson, Jonas and Strid, Hans and Andersson, Marie and Jäghult, Susanna and Eberhardson, Michael and Nordenvall, Caroline and Fagerberg, Ulrika L. and Rejler, Martin and Grip, Olof and Karling, Pontus}},
issn = {{1873-9946}},
keywords = {{epidemiology; Inflammatory bowel diseases; population-based study; spondyloarthritis}},
language = {{eng}},
month = {{10}},
number = {{10}},
pages = {{1540--1550}},
publisher = {{Oxford University Press}},
series = {{Journal of Crohn's and Colitis}},
title = {{Association Between Inflammatory Bowel Disease and Spondyloarthritis : Findings from a Nationwide Study in Sweden}},
url = {{http://dx.doi.org/10.1093/ecco-jcc/jjac065}},
doi = {{10.1093/ecco-jcc/jjac065}},
volume = {{16}},
year = {{2022}},
}