Patients With Inflammatory Bowel Disease on Treatment Have Lower Rates of Celiac Disease. Issue 3 (14th May 2021)

• Record Type: Journal Article
• Authors: Alkhayyat, Motasem; Abureesh, Mohammad; Almomani, Ashraf; Abou Saleh, Mohannad; Zmaili, Mohammad; El Ouali, Sara; Mansoor, Emad; Rubio-Tapia, Alberto; Regueiro, Miguel
• Is Part Of: Inflammatory bowel diseases. Volume 28:Issue 3(2022)
• Page Start: 385
• Page End: 392
• Publication Date: 2021-05-14
• Subjects: ulcerative colitis -- Crohn disease -- celiac disease -- immunomodulators -- biologics; Inflammatory bowel diseases -- Periodicals; Colitis, Ulcerative -- Periodicals; Crohn Disease -- Periodicals; Inflammatory Bowel Diseases -- Periodicals; 616.344
• DOI: 10.1093/ibd/izab084
• Languages: English
• ISSNs: 1078-0998

Abstract

Abstract: Background: The association between celiac disease and inflammatory bowel disease (IBD) has been studied; however, the impact of IBD therapy on celiac disease is not known. Using a large database, we sought to describe the association of celiac disease and IBD and the impact of IBD treatment. Methods: We queried a large multicenter database (Explorys Inc.), an electronic health record data aggregate from 26 American health care systems. We identified a cohort of patients with celiac disease and IBD between 1999 and 2020 and conducted a statistical analysis using a multivariate model. Results: Of the 72, 965, 940 individuals in the database, 133, 400 had celiac disease (0.18%), 191, 570 (0.26%) had ulcerative colitis (UC), and 230, 670 (0.32%) had Crohn disease (CD). Patients with IBD were more likely to have a diagnosis of celiac disease (odds ratio [OR], 13.680), with a greater association with CD. Treated patients with UC and with CD, respectively, had a lower risk association with celiac disease compared to those not undergoing IBD treatment, specifically corticosteroids (OR, 0.407 and 0.585), 5-aminosalicylates (OR, 0.124 and 0.127), immunomodulators (OR, 0.385 and 0.425), and anti-tumor necrosis factor drugs (OR, 0.215 and 0.242). There was no lower risk association in the vedolizumab group, but there was a higher risk association among the ustekinumab group. Conclusions: In this large dataset, we showed a bidirectional association between celiac disease and IBD that was stronger with CD. Patients with IBD treated using corticosteroids, 5-aminosalicylates, immunomodulators, or anti-tumor necrosis factor drugs had a lower association with celiac disease. Additional studies are required to determine the underlying mechanisms for IBD therapy–related modification of celiac disease incidence.