scholarly journals Carotid Plaque Assessment Reclassifies Patients with Inflammatory Bowel Disease into Very-High Cardiovascular Risk

2021 ◽  
Vol 10 (8) ◽  
pp. 1671
Author(s):  
Alejandro Hernández-Camba ◽  
Marta Carrillo-Palau ◽  
Laura Ramos ◽  
Noemi Hernández Alvarez-Buylla ◽  
Inmaculada Alonso-Abreu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Inflammatory Bowel Disease ◽  
Regression Analysis ◽  
Bowel Disease ◽  
Carotid Plaque ◽  
Risk Category ◽  
Carotid Ultrasound ◽  
Multivariable Regression ◽  
Inflammatory Bowel ◽  
Very High

The addition of carotid ultrasound into cardiovascular (CV) risk scores has been found to be effective in identifying patients with chronic inflammatory diseases at high-CV risk. We aimed to determine if its use would facilitate the reclassification of patients with inflammatory bowel disease (IBD) into the very high-CV-risk category and whether this may be related to disease features. In this cross-sectional study encompassing 186 IBD patients and 175 controls, Systematic Coronary Risk Evaluation (SCORE), disease activity measurements, and the presence of carotid plaques by ultrasonography were assessed. Reclassification was compared between patients and controls. A multivariable regression analysis was performed to evaluate if the risk of reclassification could be explained by disease-related features and to assess the influence of traditional CV risk factors on this reclassification. After evaluation of carotid ultrasound, a significantly higher frequency of reclassification was found in patients with IBD compared to controls (35% vs. 24%, p = 0.030). When this analysis was performed only on subjects included in the SCORE low-CV-risk category, 21% IBD patients compared to 11% controls (p = 0.034) were reclassified into the very high-CV-risk category. Disease-related data, including disease activity, were not associated with reclassification after fully multivariable regression analysis. Traditional CV risk factors showed a similar influence over reclassification in patients and controls. However, LDL-cholesterol disclosed a higher effect in controls compared to patients (beta coef. 1.03 (95%CI 1.02–1.04) vs. 1.01 (95%CI 1.00–1.02), interaction p = 0.035) after adjustment for confounders. In conclusion, carotid plaque assessment is useful to identify high-CV risk IBD patients.

scholarly journals P247 Carotid Plaque Assessment reclassifies patients with Inflammatory Bowel Disease into Very-High Cardiovascular Risk

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S289-S289
Author(s):  
A Hernandez Camba ◽  
M Carrillo-Palau ◽  
L Ramos ◽  
N Hernández Alvarez-Buylla ◽  
I Alonso-Abreu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Inflammatory Bowel Disease ◽  
Regression Analysis ◽  
Bowel Disease ◽  
Carotid Plaque ◽  
Risk Category ◽  
Carotid Ultrasound ◽  
Multivariable Regression ◽  
Inflammatory Bowel ◽  
Very High

Abstract Background The addition of carotid ultrasound into cardiovascular (CV) risk scores has been found to be effective in identifying patients with chronic inflammatory diseases at high-CV risk. We aimed to determine if its use would facilitate the reclassification of patients with inflammatory bowel disease (IBD) into the very high-CV-risk category and whether this may be related to disease features. Methods Multicenter cross-sectional study encompassing 186 IBD patients and 175 controls. Systematic Coronary Risk Evaluation (SCORE), disease activity measurements, and the presence of carotid plaques by ultrasonography were assessed. Reclassification was compared between patients and controls. A multivariable regression analysis was performed to evaluate if the risk of reclassification could be explained by disease-related features and to assess the influence of traditional CV risk factors on this reclassification. Results After evaluation of carotid ultrasound, a significantly higher frequency of reclassification was found in patients with IBD compared to controls (35% vs. 24%, p=0.030). When this analysis was performed only on subjects included in the SCORE low-CV-risk category, 21% IBD patients compared to 11% controls (p = 0.034) were reclassified into the very high-CV-risk category. Disease related data, including disease activity, were not associated with reclassification after fully multivariable regression analysis. Traditional CV risk factors showed a similar influence over reclassification in patients and controls. However, LDL-cholesterol disclosed a higher effect in controls compared to patients (beta coef. 1.03[95%CI 1.02–1.04] vs. 1.01[95%CI 1.00–1.02], interaction p=0.035) after adjustment for confounders. Conclusion Carotid plaque assessment is useful to identify high-CV risk IBD patients.

scholarly journals Treatment of Inflammatory Bowel Disease: Is your Patient at Risk of Non-Adherence?

2014 ◽  
Vol 27 (5) ◽  
pp. 576 ◽  
Author(s):  
Joana Magalhães ◽  
Francisca Dias de Castro ◽  
Pedro Boal Carvalho ◽  
Sílvia Leite ◽  
Maria João Moreira ◽  
...  
Keyword(s):  
Risk Factors ◽  
Inflammatory Bowel Disease ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Bowel Disease ◽  
Disease Duration ◽  
Adherence To Treatment ◽  
Short Disease Duration ◽  
Inflammatory Bowel ◽  
Adherence To Therapy

<p><strong>Introduction:</strong> Adherence to therapy is a key factor when analyzing the efficacy of a treatment in clinical practice. The aim of our study was to assess the frequency of non-adherence to treatment among patients with inflammatory bowel disease and evaluate which factors could be related.<br /><strong>Material and Methods:</strong> One hundred thirty eight consecutive inflammatory bowel disease outpatients (55.8% with Crohn’s disease and 44.2% with Ulcerative Colitis) filled in an anonymous questionnaire, which included information about demography, duration of the disease, specific therapy for inflammatory bowel disease, and data possibly related to extent of non-adherence to treatment. Statistics were performed with SPSS v.18.0. Categorical variables were compared with Fisher’s exact test. A p value &lt; 0.05 was considered statistically significant. Significant variables in univariate analysis were included in the logistic regression analysis.<br /><strong>Results:</strong> Overall non-adherence was reported by 29.7% of patients. 70.7% of them reported unintentional non-adherence and 51.2% forgot at least one dose per week. Non-adherence was statistically associated with: short disease duration (p &lt; 0.001); young age (p = 0.001); topical aminosalicylates (p = 0.005); the perception that medical therapy isn’t effective enough (p = 0.007) and high educational level (p = 0.011). In a logistic regression analysis, topical aminosalicylates use (p = 0.004), short disease duration (p = 0.006) and young age (p = 0.027) were identified as significant predictors of non-adherence.<br /><strong>Discussion:</strong> Young patients, patients with short disease duration and under topical aminosalicyates presented a higher risk for nonadherence to treatment.<br /><strong>Conclusions:</strong> Gastroenterologist’s attention should be focused on the identification of risk factors potentially involved in non-adherence to therapy and in the promotion of measures to improve it.</p><p><br /><strong>Keywords:</strong> Inflammatory Bowel Disease; Crohn Disease; Colitis, Ulcerative; Patient Compliance; Risk Factors; Treatment Refusal.</p>

scholarly journals Disease activity influences the reclassification of rheumatoid arthritis into very high cardiovascular risk

2021 ◽  
Vol 23 (1) ◽  
Author(s):  
Iván Ferraz-Amaro ◽  
Alfonso Corrales ◽  
Juan Carlos Quevedo-Abeledo ◽  
Nuria Vegas-Revenga ◽  
Ricardo Blanco ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Carotid Plaque ◽  
Multivariable Analysis ◽  
Risk Category ◽  
Carotid Ultrasound ◽  
Risk Reclassification ◽  
Ultrasound Assessment ◽  
Multivariable Regression ◽  
Very High

Abstract Background Previous studies have shown that risk chart algorithms, such as the Systematic Coronary Risk Assessment (SCORE), often underestimate the actual cardiovascular (CV) risk of patients with rheumatoid arthritis (RA). In contrast, carotid ultrasound was found to be useful to identify RA patients at high CV. In the present study, we aimed to determine if specific disease features influence the CV risk reclassification of RA patients assessed by SCORE risk charts and carotid ultrasound. Methods 1279 RA patients without previous CV events, diabetes, or chronic kidney disease were studied. Disease characteristics including disease activity scores, CV comorbidity, SCORE calculation, and the presence of carotid plaque by carotid ultrasound were assessed. A multivariable regression analysis was performed to evaluate if the reclassification into very high CV risk category was independently associated with specific features of the disease including disease activity. Additionally, a prediction model for reclassification was constructed in RA patients. Results After carotid ultrasound assessments, 54% of the patients had carotid plaque and consequently fulfilled definition for very high CV risk. Disease activity was statistically significantly associated with reclassification after fully multivariable analysis. A predictive model containing the presence of dyslipidemia and hypertension, an age exceeding 54 years, and a DAS28-ESR score equal or higher than 2.6 yielded the highest discrimination for reclassification. Conclusion Reclassification into very high CV risk after carotid ultrasound assessment occurs in more than the half of patients with RA. This reclassification can be independently explained by the activity of the disease.

Sa508 RISK FACTORS FOR INCIDENT INFLAMMATORY BOWEL DISEASE ACCORDING TO DISEASE PHENOTYPE

2021 ◽  
Vol 160 (6) ◽  
pp. S-528
Author(s):  
Emily W. Lopes ◽  
Kristin E. Burke ◽  
James Richter ◽  
Ashwin Ananthakrishnan ◽  
Paul Lochhead ◽  
...  
Keyword(s):  
Risk Factors ◽  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Disease Phenotype ◽  
Inflammatory Bowel

scholarly journals Anti-tumor necrosis factor-induced lupus in patients with inflammatory bowel disease: a hospital-based cohort study from Korea

2021 ◽  
Vol 14 ◽  
pp. 175628482199779
Author(s):  
Su Jin Choi ◽  
Soo Min Ahn ◽  
Ji Seon Oh ◽  
Seokchan Hong ◽  
Chang-Keun Lee ◽  
...  
Keyword(s):  
Risk Factors ◽  
Inflammatory Bowel Disease ◽  
Tumor Necrosis Factor ◽  
Bowel Disease ◽  
Tumor Necrosis ◽  
Cox Regression ◽  
Cox Regression Analysis ◽  
Inflammatory Bowel ◽  
Necrosis Factor ◽  
Mucocutaneous Symptoms

Background: Anti-tumor necrosis factor (TNF) agents are increasingly used for rheumatic diseases and inflammatory bowel disease (IBD), but are associated with the development of anti-TNF-induced lupus (ATIL). Nonetheless, few ATIL studies on non-Caucasian IBD patients exist. Here, we investigated the incidence, clinical features, and risk factors of ATIL in Korea. Methods: We retrospectively reviewed the medical records of IBD patients undergoing anti-TNF therapy at our tertiary IBD center between 2008 and 2020. ATIL was diagnosed as a temporal association between symptoms and anti-TNF agents, and the presence of at least one serologic and non-serologic American College of Rheumatology criterion. The risk factors for ATIL occurrence were assessed using multivariate Cox regression analysis. Results: Of 1362 IBD patients treated with anti-TNF agents, 50 (3.7%) ATIL cases were suspected, of which 14 (1.0%) received a definitive diagnosis. Arthritis and mucocutaneous symptoms were observed in 13 and 4 patients, respectively. All ATIL cases were positive for anti-nuclear and anti-dsDNA antibodies. Four patients (30.8%) improved while continuing anti-TNF therapy. At the final follow up, the ATIL group ( n = 14) had a lower IBD remission rate (30.8% versus 68.8%, p = 0.019) than the non-ATIL group ( n = 36). Ulcerative colitis and longer disease duration were associated with ATIL occurrence, with hazard ratios of 7.017 ( p = 0.005) and 1.118 ( p = 0.002), respectively. Conclusion: Although rare, ATIL is associated with poor treatment response to IBD in Korean patients. ATIL should be considered if arthritis and mucocutaneous symptoms develop during anti-TNF therapy for IBD.

scholarly journals A186 OLDER AGE IS ASSOCIATED WITH INCREASED EXTRAINTESTINAL MANIFESTATIONS IN INFLAMMATORY BOWEL DISEASE

2021 ◽  
Vol 4 (Supplement_1) ◽  
pp. 201-202
Author(s):  
Z Chattha ◽  
R Chattha ◽  
S Reza ◽  
M Moradshahi ◽  
M Fadida ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Regression Analysis ◽  
Bowel Disease ◽  
Multivariate Regression Analysis ◽  
Older Age ◽  
Extraintestinal Manifestations ◽  
Forward Selection ◽  
Increased Risk ◽  
Inflammatory Bowel

Abstract Background The relationship between older age and extraintestinal manifestations (EIMs) in patients with inflammatory bowel disease (IBD) remains unknown. Aims This study aims to determine whether older age is associated with increased risk of EIMs in IBD patients. Methods This was a retrospective study of IBD patients seen at the McMaster University Medical Centre, in Hamilton, ON, Canada from 2012–2020. Patients were identified to have the primary outcome of interest if their gastroenterologist documented the presence of any EIM either during the baseline assessment or during the period of follow up. The independent variable, age at start of follow-up, was dichotomized into two categories age &gt;=40 vs. &lt;40.Prior knowledge in combination with forward selection was used to develop a logistic regression model. The variables utilized for the forward selection model included gender, disease duration, and current biologic use. Results A total of 995 IBD patients (625 with CD) were considered for the regression analysis, all for whom the EIM status was recorded. Out of the 995 patients, 270 patients reported at least one EIM – 99 with arthritis/arthralgia, 79 with dermatologic manifestations, 16 with ophthalmic manifestations, 30 with liver manifestations, and 116 with other EIMs. A univariate regression analysis foundincreased odds of EIMs in older patientsas compared to younger patients (odds ratio (OR) 1.41 (95% CI, 1.05 – 1.89)). In the multivariate regression analysis, current biologic use was found to have a significant relationship with odds of having EIMs (OR 1.49; 95% CI, 1.06 – 2.09). After adjustment for biologic use, patients aged 40 or over had 1.46 times higher odds of having EIMs (95% CI 1.03 – 2.05). A sub-analysis of individual EIM categoriesdid not show a significant association with older age. Conclusions Older age is associated with increased risk of EIMs in IBD patients. Patients with EIMs were also more likely to be treated with biological therapies. Clinicians should inquire about the presence of EIMs in older IBD patients. Funding Agencies None

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