Year 2017 / Volume 109 / Number 9
Original
Prevalence, risk factors and response to treatment of extra-intestinal manifestations in patients with inflammatory bowel disease

627-633

DOI: 10.17235/reed.2017.4845/2017

María Hernández-Tejero, Alicia Granja Navacerrada, Pilar Bernal Checa, Rubén Piqué Becerra, Alicia Algaba García, Iván Guerra Marina, Francisco Javier García-Alonso, Mariano Syed, Fernando Bermejo,

Abstract
Introduction: Patients with inflammatory bowel disease can experience extra-intestinal manifestations that may cause significant morbidity. Aims: To describe the prevalence, characteristics, treatment and evolution of extra-intestinal manifestations in inflammatory bowel disease patients treated in our hospital and to identify associated risk factors. Methods: This was a retrospective, observational, case-control study. All inflammatory bowel disease patients with extra-intestinal manifestations were considered as cases and inflammatory bowel disease patients without extra-intestinal manifestations were considered as controls. Results: Six hundred and nineteen patients with inflammatory bowel disease (327 Crohn’s disease, 265 ulcerative colitis, 27 indeterminate colitis) were included in the study; 16.5% experienced at least one extra-intestinal manifestation (CI 95% 13.5-19.5; n = 102). The most frequent extra-intestinal manifestations observed were musculoskeletal (n = 50; 40%) and cutaneous manifestations (n = 50; 40%). With regard to treatment, arthropathies were treated with non-steroidal anti-inflammatory drugs (31%) and corticosteroids (19%, oral or intra-articular), and the majority of the cutaneous manifestations were managed with corticosteroids. Overall, the efficacy of extra-intestinal manifestation treatment was 90% and only 13% of patients had a recurrence of extra-intestinal manifestations. The multivariate analysis showed that female gender (p = 0.012; OR = 1.61; 95% CI 1.11-2.34) and the severity of inflammatory bowel disease (p = 0.009; OR = 1.65; 95% CI 1.13-2.4 if immunosuppressant therapy alone, or p = 0.029; OR = 2.28; 95% CI 1.09-4.78 if in combination with adalimumab) were associated with an increased risk of developing extra-intestinal manifestations. Conclusions: The most frequent extra-intestinal manifestations in our environment were musculoskeletal and cutaneous manifestations. Female gender and a more severe disease were associated with a higher risk of developing extra-intestinal manifestations. Individualized treatment of extra-intestinal manifestations is effective and the risk is low in our series.
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Hernández-Tejero M, Granja Navacerrada A, Bernal Checa P, Piqué Becerra R, Algaba García A, Guerra Marina I, et all. Prevalence, risk factors and response to treatment of extra-intestinal manifestations in patients with inflammatory bowel disease. 4845/2017


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Publication history

Received: 16/01/2017

Accepted: 20/05/2017

Online First: 27/07/2017

Published: 31/08/2017

Article revision time: 123 days

Article Online First time: 192 days

Article editing time: 227 days


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