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. 2024 Sep;12(7):870-878.
doi: 10.1002/ueg2.12635. Epub 2024 Jul 29.

Prevalence of stricturing, penetrating complications and extraintestinal manifestations in inflammatory bowel disease detected on cross-sectional imaging in a tertiary care setting

Sudheer Kumar Vuyyuru  1 , Virginia Solitano  1   2   3 , Achuthan Aruljothy  1 , Maan Alkhattabi  4 , Melanie Beaton  1 , Jamie Gregor  1 , Zahra Kassam  5 , Harry Marshall  5 , Darryl Ramsewak  5 , Rocio Sedano  1   6 , Michael Sey  1   7 , Vipul Jairath  1   6   7
Affiliations

Prevalence of stricturing, penetrating complications and extraintestinal manifestations in inflammatory bowel disease detected on cross-sectional imaging in a tertiary care setting

Sudheer Kumar Vuyyuru et al. United European Gastroenterol J. 2024 Sep.

Abstract

Background: Stricturing, penetrating complications and extraintestinal manifestations (EIMs) are frequent in patients with inflammatory bowel disease (IBD). There is limited data on the prevalence of these complications in patients with IBD. Therefore, we aimed to assess the burden of these complications detected incidentally on cross-sectional imaging.

Methods: A retrospective study conducted at two tertiary care centers in London, Ontario. Patients (≥18 years) with a confirmed diagnosis of IBD who underwent CT enterography (CTE) or MR enterography (MRE) between 1 Jan 2010 and 31 Dec 2018 were included. Categorical variables were reported as proportions and the mean and standard deviations were reported for continuous variables.

Results: A total of 615 imaging tests (MRE: 67.3% [414/615]) were performed in 557 IBD patients (CD: 91.4% [509/557], UC: 8.6% [48/557]). 38.2% (213/557) of patients were male, with mean age of 45.6 years (±15.8), and median disease duration of 11.0 years (±12.5). Among patients with CD, 33.2% (169/509) had strictures, with 7.8% having two or more strictures and 66.3% considered inflammatory. A fistula was reported in 10.6% (54/509), the most common being perianal fistula (27.8% [15/54]), followed by enterocutaneous fistula (16.8% [9/54]), and enteroenteric fistula (16.8% [9/54]). Additionally, 7.4% (41/557) of patients with IBD were found to have an EIM on cross-sectional imaging, with the most prevalent EIM being cholelithiasis (63.4% [26/41]), followed by sacroiliitis (24.4% [10/41]), primary sclerosing cholangitis (4.8% [2/41]) and nephrolithiasis (4.8% [2/41]).

Conclusions: Approximately 40% of patients with CD undergoing cross-sectional imaging had evidence of a stricture or fistulizing disease, with 7% of patients with IBD having a detectable EIM. These results highlight the burden of disease and the need for specific therapies for these disease phenotypes.

Keywords: Crohn's disease; EIMs; IBD; IMIDs; MRE; computed tomography enterography; disease behavior; magnetic resonance enterography; stenosing; ulcerative colitis.

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Conflict of interest statement

Sudheer Kumar Vuyyuru: Has received consulting fees from Alimentiv. Virginia Solitano: None. Achuthan Aruljothy: None. Maan Alkhattabi: Consulting fees from Janssen. Speaker's fees from Janssen, Takeda & Pfizer. Melanie Beaton: Has received honoraria/advisory board fees from AbbVie, Takeda, Janssen, Lupin, Gilead, Pfizer, Novo Nordisk, McKesson, Shire and Allergan. Jamie Gregor: Has received speakers fees from AbbVie, Janssen, Takeda, Celltrion, Organon and Ferring. Zahra Kassam: Bayer Pharmaceuticals—speaker honoraria and research funding, Alimentiv Inc. Consulting fees and Fusion MD speaker fees. Harry Marshall: None. Darryl Ramsewak: None. Rocio Sedano: Has received consulting fee from Alimentiv. Michael Sey: Has received consultant fees from Medtronic; Research grants and speaker fees from Pendopharm; Educational grant from Cook Medical. Vipul Jairath: has received has received consulting/advisory board fees from AbbVie, Alimentiv Inc, Arena pharmaceuticals, Asahi Kasei Pharma, Asieris, Astra Zeneca, Bristol Myers Squibb, Celltrion, Eli Lilly, Ferring, Flagship Pioneering, Fresenius Kabi, Galapagos, GlaxoSmithKline, Genentech, Gilead, Janssen, Merck, Mylan, Pandion, Pendopharm, Pfizer, Protagonist, Prometheus, Reistone Biopharma, Roche, Sandoz, Second Genome, Takeda, Teva, Topivert, Ventyx, and Vividion; Speaker's fees from, Abbvie, Ferring, Galapagos, Janssen Pfizer Shire, Takeda, and Fresenius Kabi.

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