The Association of Inflammatory Bowel Disease with Coeliac Disease and Coeliac Autoimmunity in Children and Adults: A Nationwide Study from the epi-IIRN

Michal Kori; Yonatan Zamir; Sami Or Yermiyahu; Inessa Ainbinder; Svetlana Daichman; Gavriel David Pinto; Yiska Loewenberg Weisband; Shira Greenfeld; Revital Kariv; Natan Lederman; Eran Matz; Raanan Shamir; Iris Dotan; Dan Turner

doi:10.1093/ecco-jcc/jjac176

The Association of Inflammatory Bowel Disease with Coeliac Disease and Coeliac Autoimmunity in Children and Adults: A Nationwide Study from the epi-IIRN

Michal Kori^*, Yonatan Zamir, Sami Or Yermiyahu, Inessa Ainbinder, Svetlana Daichman, Gavriel David Pinto, Yiska Loewenberg Weisband, Shira Greenfeld, Revital Kariv, Natan Lederman, Eran Matz, Raanan Shamir, Iris Dotan, Dan Turner

^*Corresponding author for this work

Faculty of Medicine

Research output: Contribution to journal › Article › peer-review

4 Scopus citations

Abstract

Background and Aims: Given the paucity of population-based data on the association between inflammatory bowel diseases [IBD], coeliac disease [CeD], and coeliac autoimmunity [CeA] we aimed to study the associations in a nationwide study. Methods: Using health administrative data for all four health maintenance organisations in Israel, covering 98% of the population, we explored the prevalence of CeD in children and adults with IBD versus non-IBD matched controls. CeD was defined by three ICD-9 codes and CeA by positivity for tissue transglutaminase antibodies. Results: In total, 34 375 IBD patients (56% Crohn’s disease [CD] and 44% ulcerative colitis [UC]) were compared with 93 603 non-IBD controls. Among IBD patients, 319 [0.93%] had CeD versus 294 [0.31%] non-IBD controls (odds ratio [OR] = 2.97, 95% confidence interval [CI] 2.54-3.48; p <0.001). CeA was identified in 575 [1.67%] IBD patients vs 158 [0.17%] controls [OR = 10.06, 95% CI 8.43-12; p <0.001]. The prevalence of CeD was higher in paediatric-onset IBD (87/5243 [1.66%]) than adult-onset IBD (232/29 132 [0.79%]; p <0.001). CD patients had a higher prevalence of CeD (229/19 264 [1.19%]) than UC patients (90/15 111 [0.56%]; OR = 2.01, 95% CI 1.57-2.56; p <0.001). The diagnosis of CeD preceded the diagnosis of IBD in 241/319 cases [76%]. The time to treatment escalation was shorter in patients with both IBD and CeD than in patients with IBD without CeD [p = 0.017]. Conclusion: CeD and CeA are more prevalent in IBD patients, especially in paediatric-onset IBD and in CD. The diagnosis of CeD usually precedes that of IBD. Having CeD is associated with more intensified treatment for IBD.

Original language	American English
Pages (from-to)	700-705
Number of pages	6
Journal	Journal of Crohn's and Colitis
Volume	17
Issue number	5
DOIs	https://doi.org/10.1093/ecco-jcc/jjac176
State	Published - 1 May 2023

Bibliographical note

Funding Information:
The epi-IIRN project has been funded by an educational grant from the Leona M. and Harry B. Helmsley Charitable Trust. The authors would like to thank Chagit Friss, Rona Lujan, Adi Mendelovici, and Gili Focht for their assistance in data collection, analysis, and support of the study.

Publisher Copyright:
© The Author(s) 2022.

Keywords

Inflammatory bowel disease
coeliac autoimmunity
coeliac disease

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10.1093/ecco-jcc/jjac176

Cite this

Kori, M., Zamir, Y., Yermiyahu, S. O., Ainbinder, I., Daichman, S., Pinto, G. D., Weisband, Y. L., Greenfeld, S., Kariv, R., Lederman, N., Matz, E., Shamir, R., Dotan, I., & Turner, D. (2023). The Association of Inflammatory Bowel Disease with Coeliac Disease and Coeliac Autoimmunity in Children and Adults: A Nationwide Study from the epi-IIRN. Journal of Crohn's and Colitis, 17(5), 700-705. https://doi.org/10.1093/ecco-jcc/jjac176

@article{f979af53110d4930a383f3f93b7c651e,

title = "The Association of Inflammatory Bowel Disease with Coeliac Disease and Coeliac Autoimmunity in Children and Adults: A Nationwide Study from the epi-IIRN",

abstract = "Background and Aims: Given the paucity of population-based data on the association between inflammatory bowel diseases [IBD], coeliac disease [CeD], and coeliac autoimmunity [CeA] we aimed to study the associations in a nationwide study. Methods: Using health administrative data for all four health maintenance organisations in Israel, covering 98% of the population, we explored the prevalence of CeD in children and adults with IBD versus non-IBD matched controls. CeD was defined by three ICD-9 codes and CeA by positivity for tissue transglutaminase antibodies. Results: In total, 34 375 IBD patients (56% Crohn{\textquoteright}s disease [CD] and 44% ulcerative colitis [UC]) were compared with 93 603 non-IBD controls. Among IBD patients, 319 [0.93%] had CeD versus 294 [0.31%] non-IBD controls (odds ratio [OR] = 2.97, 95% confidence interval [CI] 2.54-3.48; p <0.001). CeA was identified in 575 [1.67%] IBD patients vs 158 [0.17%] controls [OR = 10.06, 95% CI 8.43-12; p <0.001]. The prevalence of CeD was higher in paediatric-onset IBD (87/5243 [1.66%]) than adult-onset IBD (232/29 132 [0.79%]; p <0.001). CD patients had a higher prevalence of CeD (229/19 264 [1.19%]) than UC patients (90/15 111 [0.56%]; OR = 2.01, 95% CI 1.57-2.56; p <0.001). The diagnosis of CeD preceded the diagnosis of IBD in 241/319 cases [76%]. The time to treatment escalation was shorter in patients with both IBD and CeD than in patients with IBD without CeD [p = 0.017]. Conclusion: CeD and CeA are more prevalent in IBD patients, especially in paediatric-onset IBD and in CD. The diagnosis of CeD usually precedes that of IBD. Having CeD is associated with more intensified treatment for IBD.",

keywords = "Inflammatory bowel disease, coeliac autoimmunity, coeliac disease",

author = "Michal Kori and Yonatan Zamir and Yermiyahu, {Sami Or} and Inessa Ainbinder and Svetlana Daichman and Pinto, {Gavriel David} and Weisband, {Yiska Loewenberg} and Shira Greenfeld and Revital Kariv and Natan Lederman and Eran Matz and Raanan Shamir and Iris Dotan and Dan Turner",

note = "Funding Information: The epi-IIRN project has been funded by an educational grant from the Leona M. and Harry B. Helmsley Charitable Trust. The authors would like to thank Chagit Friss, Rona Lujan, Adi Mendelovici, and Gili Focht for their assistance in data collection, analysis, and support of the study. Publisher Copyright: {\textcopyright} The Author(s) 2022.",

year = "2023",

month = may,

day = "1",

doi = "10.1093/ecco-jcc/jjac176",

language = "American English",

volume = "17",

pages = "700--705",

journal = "Journal of Crohn's and Colitis",

issn = "1873-9946",

publisher = "Oxford University Press",

number = "5",

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Kori, M, Zamir, Y, Yermiyahu, SO, Ainbinder, I, Daichman, S, Pinto, GD, Weisband, YL, Greenfeld, S, Kariv, R, Lederman, N, Matz, E, Shamir, R, Dotan, I & Turner, D 2023, 'The Association of Inflammatory Bowel Disease with Coeliac Disease and Coeliac Autoimmunity in Children and Adults: A Nationwide Study from the epi-IIRN', Journal of Crohn's and Colitis, vol. 17, no. 5, pp. 700-705. https://doi.org/10.1093/ecco-jcc/jjac176

TY - JOUR

T1 - The Association of Inflammatory Bowel Disease with Coeliac Disease and Coeliac Autoimmunity in Children and Adults

T2 - A Nationwide Study from the epi-IIRN

AU - Kori, Michal

AU - Zamir, Yonatan

AU - Yermiyahu, Sami Or

AU - Ainbinder, Inessa

AU - Daichman, Svetlana

AU - Pinto, Gavriel David

AU - Weisband, Yiska Loewenberg

AU - Greenfeld, Shira

AU - Kariv, Revital

AU - Lederman, Natan

AU - Matz, Eran

AU - Shamir, Raanan

AU - Dotan, Iris

AU - Turner, Dan

N1 - Funding Information: The epi-IIRN project has been funded by an educational grant from the Leona M. and Harry B. Helmsley Charitable Trust. The authors would like to thank Chagit Friss, Rona Lujan, Adi Mendelovici, and Gili Focht for their assistance in data collection, analysis, and support of the study. Publisher Copyright: © The Author(s) 2022.

PY - 2023/5/1

Y1 - 2023/5/1

N2 - Background and Aims: Given the paucity of population-based data on the association between inflammatory bowel diseases [IBD], coeliac disease [CeD], and coeliac autoimmunity [CeA] we aimed to study the associations in a nationwide study. Methods: Using health administrative data for all four health maintenance organisations in Israel, covering 98% of the population, we explored the prevalence of CeD in children and adults with IBD versus non-IBD matched controls. CeD was defined by three ICD-9 codes and CeA by positivity for tissue transglutaminase antibodies. Results: In total, 34 375 IBD patients (56% Crohn’s disease [CD] and 44% ulcerative colitis [UC]) were compared with 93 603 non-IBD controls. Among IBD patients, 319 [0.93%] had CeD versus 294 [0.31%] non-IBD controls (odds ratio [OR] = 2.97, 95% confidence interval [CI] 2.54-3.48; p <0.001). CeA was identified in 575 [1.67%] IBD patients vs 158 [0.17%] controls [OR = 10.06, 95% CI 8.43-12; p <0.001]. The prevalence of CeD was higher in paediatric-onset IBD (87/5243 [1.66%]) than adult-onset IBD (232/29 132 [0.79%]; p <0.001). CD patients had a higher prevalence of CeD (229/19 264 [1.19%]) than UC patients (90/15 111 [0.56%]; OR = 2.01, 95% CI 1.57-2.56; p <0.001). The diagnosis of CeD preceded the diagnosis of IBD in 241/319 cases [76%]. The time to treatment escalation was shorter in patients with both IBD and CeD than in patients with IBD without CeD [p = 0.017]. Conclusion: CeD and CeA are more prevalent in IBD patients, especially in paediatric-onset IBD and in CD. The diagnosis of CeD usually precedes that of IBD. Having CeD is associated with more intensified treatment for IBD.

AB - Background and Aims: Given the paucity of population-based data on the association between inflammatory bowel diseases [IBD], coeliac disease [CeD], and coeliac autoimmunity [CeA] we aimed to study the associations in a nationwide study. Methods: Using health administrative data for all four health maintenance organisations in Israel, covering 98% of the population, we explored the prevalence of CeD in children and adults with IBD versus non-IBD matched controls. CeD was defined by three ICD-9 codes and CeA by positivity for tissue transglutaminase antibodies. Results: In total, 34 375 IBD patients (56% Crohn’s disease [CD] and 44% ulcerative colitis [UC]) were compared with 93 603 non-IBD controls. Among IBD patients, 319 [0.93%] had CeD versus 294 [0.31%] non-IBD controls (odds ratio [OR] = 2.97, 95% confidence interval [CI] 2.54-3.48; p <0.001). CeA was identified in 575 [1.67%] IBD patients vs 158 [0.17%] controls [OR = 10.06, 95% CI 8.43-12; p <0.001]. The prevalence of CeD was higher in paediatric-onset IBD (87/5243 [1.66%]) than adult-onset IBD (232/29 132 [0.79%]; p <0.001). CD patients had a higher prevalence of CeD (229/19 264 [1.19%]) than UC patients (90/15 111 [0.56%]; OR = 2.01, 95% CI 1.57-2.56; p <0.001). The diagnosis of CeD preceded the diagnosis of IBD in 241/319 cases [76%]. The time to treatment escalation was shorter in patients with both IBD and CeD than in patients with IBD without CeD [p = 0.017]. Conclusion: CeD and CeA are more prevalent in IBD patients, especially in paediatric-onset IBD and in CD. The diagnosis of CeD usually precedes that of IBD. Having CeD is associated with more intensified treatment for IBD.

KW - Inflammatory bowel disease

KW - coeliac autoimmunity

KW - coeliac disease

UR - http://www.scopus.com/inward/record.url?scp=85147859048&partnerID=8YFLogxK

U2 - 10.1093/ecco-jcc/jjac176

DO - 10.1093/ecco-jcc/jjac176

M3 - Article

C2 - 36394548

AN - SCOPUS:85147859048

SN - 1873-9946

VL - 17

SP - 700

EP - 705

JO - Journal of Crohn's and Colitis

JF - Journal of Crohn's and Colitis

IS - 5

ER -

The Association of Inflammatory Bowel Disease with Coeliac Disease and Coeliac Autoimmunity in Children and Adults: A Nationwide Study from the epi-IIRN

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Bibliographical note

Keywords

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