S0657 Prevalence and Odds Ratios of Extraintestinal Manifestations in Inflammatory Bowel Disease in the United States Between 2014 and 2019: A Population-Based Study

INTRODUCTION: Extraintestinal manifestations (EIM) of inflammatory bowel disease (IBD) are increasing in prevalence. However, epidemiologic data have mostly been acquired from smaller studies. We sought to describe the epidemiology of EIMs in the United States utilizing a large database. To our knowledge, no large study has been performed to evaluate the prevalence of EIM of IBD. METHODS: We queried a commercial database (Explorys Inc, Cleveland, OH), an aggregate of electronic health record data from 26 major integrated US healthcare systems, from 1999 to 2019. We identified an aggregated patient cohort of eligible patients with IBD between October 2014 and October 2019 based on Systematized Nomenclature of Medicine—Clinical Terms (SNOMED-CT) of Crohn's disease (CD) and ulcerative colitis (UC). In this cohort we identified diagnoses of the following EIMs: uveitis, iritis, erythema nodosum (EN), pyoderma gangrenosum (PG), aphthous ulcer of mouth, arthritis, ankylosing spondylitis (AS), and psoriasis. We calculated the prevalence and odds ratios of each EIM in CD versus UC in the overall population and within certain age ranges. We also analyzed the gender and racial breakdown of EIMs in IBD in a similar fashion with a specific race versus all other races and females versus males. RESULTS: There were 35,333,980 persons active in the database from October 2014 and 2019. There were 159,879 cases of CD and 134,980 cases of UC respectively. The prevalence and odds ratio for each EIM in CD versus UC is in Table 1. For age <18 there was a higher prevalence of arthritis and EN. In ages 18–65 there was higher prevalence of AS, psoriasis, and EN. For age >65 there was higher prevalence of arthritis, AS, and psoriasis [Table 2]. Racial and gender breakdown were also performed (Table 3). The prevalence of iritis, aphthous ulcer of mouth, arthritis, AS, and psoriasis was increased in Caucasians while the prevalence of uveitis, iritis, EN, and PG was increased in African Americans. The prevalence of uveitis, iritis, EN, PG, aphthous ulcer of mouth, arthritis was increased in females. CONCLUSION: We sought to describe the epidemiology of EIMs of IBD. Arthritis is by far the most prevalent EIM in IBD. All EIMs are more likely to occur in CD when compared to UC in all age groups with one exception: AS is more likely to occur in UC than CD for age < 18. Caucasians and African Americans with IBD are more likely to develop certain EIMs. Females with IBD are more likely to develop all EIMs except AS.Table 1.: Overall prevalence of EIM in CD and UC and odds ratio of EIM in CD versus UCTable 2.: Statistically significant odds ratio of certain EIM per age groups in CD versus UCTable 3.: Analysis of statistically significant odds ratios for specific EIM in regard to race and gender