Prevalence of and factors associated with extraintestinal manifestations and their remission in inflammatory bowel disease: the EXTRA prospective study from the GETAID

Lucas Guillo (1) , Guillaume Savoye (2, 3, 4, 5) , Aurélien Amiot (6, 7) , Cyrielle Gilletta (8) , Maria Nachury (9, 10) , Nina Dib (11, 12) , Arnaud Bourreille (13, 14, 15) , Xavier Roblin (16) , Ludovic Caillo (17) , Matthieu Allez (18, 19) , Laurence Picon (20) , Xavier Hébuterne (21) , Philippe Seksik (22, 23) , Antoine Chupin (24) , Anthony Buisson (25, 26) , Hédia Brixi (27) , Romain Altwegg (28) , Marion Simon (29) , Morgane Amil (30) , David Laharie (31) , Guillaume Bouguen (32) , Mélanie Serrero (1) , Yasmine Elgharabawy (33) , Laurent Peyrin-Biroulet (34, 35)

1 CHU Marseille
2 ADEN - Nutrition, Inflammation et axe Microbiote-Intestin-Cerveau
3 IRIB - Institute for Research and Innovation in Biomedicine
4 UNIROUEN - Université de Rouen Normandie
5 Service d'Hépato-Gastroentérologie [CHU Rouen]
6 Service de gastro-entérologie [Henri Mondor AP-HP, Créteil]
7 EC2M3 - Early detection of Colon Cancer using Molecular Markers and Microbiota (EA 7375)
8 Service Gastroentérologie, hépatologie nutrition, diabétologie et maladies héréditaires du métabolisme pédiatrique [CHU Toulouse]
9 CHRU Lille - Centre Hospitalier Régional Universitaire [CHU Lille]
10 INFINITE (Ex-Liric) - Institute for Translational Research in Inflammation - U 1286
11 CHU Angers - Centre Hospitalier Universitaire d'Angers
12 HIFIH - Hémodynamique, Interaction Fibrose et Invasivité tumorales Hépatiques
13 CIC Nantes - Centre d’Investigation Clinique de Nantes
14 CHU Nantes - Centre Hospitalier Universitaire de Nantes = Nantes University Hospital
15 Institut des Maladies de l'Appareil Digestif
16 Service de Gastro-entérologie et Hépatologie [CHU Saint-Etienne]
17 CHU Nîmes - Centre Hospitalier Universitaire de Nîmes
18 AP-HP - Hopital Saint-Louis [AP-HP]
19 EMily (UMR_S_1160 / U1160) - Ecotaxie, microenvironnement et développement lymphocytaire
20 CHU Trousseau [Tours]
21 CHU Nice - Centre Hospitalier Universitaire de Nice
22 CHU Saint-Antoine [AP-HP]
23 CRSA - Centre de Recherche Saint-Antoine
24 HEGP - Hôpital Européen Georges Pompidou [APHP]
25 3IHP - Infection Inflammation et Interaction Hôtes Pathogènes [CHU Clermont-Ferrand]
26 M2iSH - Microbes, Intestin, Inflammation et Susceptibilité de l'Hôte
27 CHU Reims - Hôpital universitaire Robert Debré [Reims]
28 Département d'Hépato-Gastroentérologie et de Transplantation Hépatique [CHU Saint-Eloi]
29 IMM - Institut Mutualiste de Montsouris
30 CHD Vendée - Centre Hospitalier Départemental - Hôpital de La Roche-sur-Yon
31 Hôpital Haut-Lévêque [CHU Bordeaux]
32 Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Ponchaillou]
33 GETAID - Groupe d’Étude Thérapeutique des Affections Inflammatoires du Tube Digestif
34 Service d'Hépato-gastro-entérologie [CHRU Nancy]
35 NGERE - Nutrition-Génétique et Exposition aux Risques Environnementaux

Abstract Background and aims: Extraintestinal manifestations (EIM) of inflammatory bowel disease (IBD) are challenging clinical situation. No prospective study assessed remission risk factors for EIMs. Study aimed to prospectively investigate the epidemiology, risk factors for EIM occurrence and EIM remission in a large IBD cohort. Methods: We conducted a cross-sectional study in 30 French referral centers. Between May to June 2021, all consecutive patients attending to hospital appointment were systematically invited to fill out a questionnaire. Results: A total of 1971 consecutive patients with IBD were analyzed. There were 1056 women (53.8%), and the median age of patients was 41 years [31; 54]. The median disease duration was 11 years [1; 18]. Overall, 544 (27.6%) had at least one EIM. In 20.2% of case, patient had multiple EIMs. The most frequent EIMs were rheumatological (19%) and dermatological (10%) manifestations. Immunosuppressant treatment (OR=2.56; p<0.001) was a risk factor for EIM, while the Montreal A3 classification (OR=0.61, p=0.023) and male gender (OR=0.61, p<0.001) were associated with a lower risk for EIM occurrence. IBD current clinical remission (OR=2.42; p<0.001) and smoking cessation (OR=2.98; p<0.001) were associated factors for EIM remission. Conversely, age at IBD diagnosis (OR=0.98; p<0.018) was associated with a lower risk of EIM remission. Conclusion: One quarter of patients had at least one EIM. Beyond factors associated with the presence of EIMs, patients with IBD current clinical remission and smoking cessation are more likely to achieve EIM remission, while increasing age at IBD diagnosis is associated with decreased chance of remission.

Domaines: Sciences du Vivant [q-bio]

Lucas Guillo, Guillaume Savoye, Aurélien Amiot, Cyrielle Gilletta, Maria Nachury, et al.. Prevalence of and factors associated with extraintestinal manifestations and their remission in inflammatory bowel disease: the EXTRA prospective study from the GETAID. Clinical and translational gastroenterology, 2023, 14 (12), pp.e00607. ⟨10.14309/ctg.0000000000000607⟩. ⟨hal-04206330⟩