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Poster presentations: Epidemiology 2020

P816 Association of autoimmune rheumatic disease with inflammatory bowel disease: a nationwide population-based study

D. Baek1, H.S. Lee2, S.B. Park3, H.K. Song4, B.I. Jang5, J.H. Bae6, H.J. Goong7, H.S. Kang8, S.H. Jung9, T.O. Kim10, G.A. Song1, E.Y. Park1

1Pusan National University School of Medicine & Pusan National University Hospital, Internal Medicine, Busan, Republic of Korea, 2Inje University Busan Paik Hospital, Internal Medicine, Busan, Republic of Korea, 3Pusan National University Yangsan Hospital, Internal Medicine, Yangsan, Republic of Korea, 4Ewha Womans University College of Medicine, Internal Medicine, Seoul, Republic of Korea, 5Yeungnam University College of Medicine, Internal Medicine, Daegu, Republic of Korea, 6Healthcare System Gangnam Center, Seoul National University Hospital, Internal Medicine, Seoul, Republic of Korea, 7Soonchunhyang University Bucheon Hospital, Gastroenterology and Hepatology, Bucheon, Republic of Korea, 8Hallym University Sacred Heart Hospital, Internal Medicine-, Anyang, Republic of Korea, 9The Catholic University of Korea, Internal Medicine, Seoul, Republic of Korea, 10Inje university Haeundae Paik Hospital, Internal Medicine, Busan, Republic of Korea

Background

Increasing evidence demonstrated that inflammatory bowel disease (IBD) has a shared genetic background with autoimmune rheumatic diseases (ARDs). However, the association between these two disease entities is not vigorously elucidated. The aim of this study is to investigate the prevalence and association between IBD and ARDs.

Methods

A nationwide population-based cross-sectional study was performed using the Korean National Health Insurance Claims database according to ICD-10 codes (Table 1). The prevalence of ARDs, including systemic lupus erythematosus (SLE), inflammatory myositis (polymyositis (PM) and dermatomyositis (DM)), systemic sclerosis (SSc), Sjogren’s syndrome (SjS), ankylosing spondylitis (AS), and rheumatoid arthritis (RA), was determined in patients with inflammatory bowel disease, compared with general populations.

Table 1. ICD‐10 codes applied to the Health Insurance Review and Assessment Service‐National Patient Sample data

ICD-10 codeDiagnosis
K50Crohn’s disease
K51Ulcerative colitis
M05, M06Rheumatoid arthritis
M32Systemic lupus erythematous
M33Dermatopolymyositis
M34Systemic sclerosis
M350Sjogren’s syndrome
M45Ankylosing spondylitis

Results

A total of 82,480 IBD patients (57,382 patients with ulcerative colitis and 25,098 with Crohn’s disease) were enrolled. The analysis revealed that patient with IBD had higher risk of being concomitantly affected by AS and RA (Table 2). Other ARDs, such as SLE, inflammatory myositis, SSc, and SjS were not associated with IBD.

Table 2. The prevalence of autoimmune rheumatic diseases in inflammatory bowel disease, compared with general populations

Prevalence
General population (n = 51,362,000)IBD (n = 82,480)UC (n = 57,382)CD (n = 25,098)
All ARDs
Rheumatoid arthritis255,080 (0.5%)1108 (1.34%)887 (1.55%)221 (0.88%)
Systemic lupus erythematous23,819 (0.05%)77 (0.09%)54 (0.09%)23 (0.09%)
Dermatomyositis/polymyositis3,048 (0.01%)11 (0.01%)8 (0.01%)3 (0.01%)
Systemic sclerosis3,902 (0.01%)14 (0.02%)8 (0.01%)6 (0.02%)
Sjogren’s syndrome47,876 (0.09%)57 (0.07%)45 (0.08%)12 (0.05%)
Ankylosing spondylitis41,797 (0.08%)674 (0.82%)506 (0.88%)168 (0.67%)

Conclusion

This nationwide population-based study demonstrated that RA and AS showed higher incidence in IBD patients. This result suggests that etiopathogenesis of IBD might be shared with RA and AS.