The association of inflammatory bowel diseases with autoimmune disorders: A report from the epi-iirn

Shahar Bar Yehuda, Rachel Axlerod, Ori Toker, Nir Zigman, Iris Goren, Vered Mourad, Natan Lederman, Nurit Cohen, Eran Matz, Doron Dushnitzky, Matan Gavish, Nirit Borovsky, Doron Schwarts, Iris Dotan, Dan Turner*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

28 Scopus citations

Abstract

Background and Aims: There are conflicting data on the association between inflammatory bowel diseases [IBD] and autoimmunity disorders. The aim of this study was to explore this association including the effect of medications. Methods: We utilized health administrative data collected by three of the four health maintenance organizations [HMOs] in Israel, covering 52% of the country's population. We explored the prevalence of the following autoimmune disorders: Insulin-dependent diabetes mellitus [IDDM], psoriasis, Sjögren syndrome, coeliac disease, systemic lupus erythematosus [SLE], primary sclerosis cholangitis [PSC] and autoimmune thyroiditis, among all IBD patients vs non-IBD controls. Case ascertainment was determined according to validated computerized algorithms. Results: In total, 12 625 IBD patients were compared to 12 625 controls. A total of 1395 [11.1%] IBD patients had at least one autoimmune disease compared with 740 [5.9%] of non-IBD controls (odds ratio [OR] = 1.99 [95% confidence interval 1.81-2.19]; p < 0.05); all autoimmune diseases, except for thyroiditis, were more prevalent among IBD patients. Adjusted for confounding variables, antitumour necrosis factor [anti-TNF] medications were associated with a higher prevalence of psoriasis (54 [5.7%] in IBD vs 177 [4.1%] in controls; OR = 1.50 [1.07-2.08]; p < 0.05) but lower prevalence of Sjögren (1 [0.1%] vs 39 [0.9%]; OR [95% CI] = 0.13 [0.02-0.94]; p < 0.05) and coeliac disease (11 [1.2%] vs 68 [1.6%]; OR [95% CI] = 0.51 [0.27-0.99]; p < 0.05). Thiopurines and 5-aminosalicylates were not associated with any autoimmune disorder. Conclusion: IBD is associated with all autoimmune diseases explored here except for thyroiditis. Anti- TNF users have a higher prevalence of psoriasis, and lower prevalence of Sjögren and coeliac disease.

Original languageAmerican English
Pages (from-to)324-329
Number of pages6
JournalJournal of Crohn's and Colitis
Volume13
Issue number3
DOIs
StatePublished - 26 Mar 2019

Bibliographical note

Publisher Copyright:
Copyright © 2018 European Crohn's and Colitis Organisation (ECCO).

Keywords

  • Admistrative research
  • Autoimmune thyroiditis
  • Coeliac disease
  • Crohn disease
  • Epi-iirn
  • Inflammatory bowel diseases
  • Insulin-dependent diabetes mellitus
  • Primary sclerosis cholangitis
  • Psoriasis
  • Sjogren syndrome
  • Systemic lupus erythematosus
  • Ulcerative colitis

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