Hidradenitis Suppurativa Associated With Higher Risk for Inflammatory Bowel Disease

Patients with hidradenitis suppurativa (HS) have more than double the risk for inflammatory bowel disease (IBD) compared with patients without a chronic inflammatory skin disease (CISD), according to study results presented at the 2022 Annual Meeting of the American Academy of Dermatology (AAD), held from March 25 to 29, 2022 in Boston, Massachusetts.

Researchers compared the incidence of overall IBD, ulcerative colitis (UC), and Crohn disease (CD) in patients with CISDs vs those incidence rates in patients without a CISD. The study authors used claims data from the nationwide Optum health care database (2004-2019) to assess 5 mutually exclusive CISD patient groups—psoriasis, atopic dermatitis, alopecia areata, vitiligo, and HS.

Overall IBD, UC, and CD were the main outcomes. The median follow-up was 718 days and lasted until an IBD event, death, disenrollment, or data stream end.

Participants included 83,049 patients with psoriasis, 123,614 with atopic dermatitis, 18,135 with alopecia areata, 9003 with vitiligo, and 6806 with HS. A total of 2,376,120 comparator patients without a CISD were also included.

An increased risk for UC (hazard ratio [HR]_UC = 2.30; 1.61-3.28) and CD (HR_CD = 2.70; 1.69-4.32) was found in patients with hidradenitis suppurativa, an increased risk for CD (HR_CD = 1.23; 1.03-1.46) was observed in patients with psoriasis, and no increased risk for IBD was found in patients with atopic dermatitis, alopecia areata, or vitiligo, after propensity score adjustment for IBD risk factors.

In a subgroup analysis of children aged 2 to 17 years, an increased incidence rate (IR) of CD was found in those with atopic dermatitis (IR_CD = 0.54 per 1000 person-years), compared with non-CISD children (IR_CD = 0.30). An increased risk was also found in those with psoriasis (IR_CD = 0.75) and hidradenitis suppurativa (IR = 1.6), but it was based on very few events.

“After controlling for relevant IBD risk factors in a representative dermatology patient population, this cohort study found that IBD was increased in patients with HS,” stated the study authors. “Crohn disease alone was meaningfully increased in patients with psoriasis and numerically increased in those with vitiligo; neither ulcerative colitis or Crohn disease was increased in patients with atopic dermatitis or alopecia areata.”

Disclosure: Some of the study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.

Reference

Schneeweiss MC, Kirchgesner J, Wyss R, et al. Inflammatory bowel disease in patients with chronic inflammatory skin diseases. Presented at: the 2022 Annual Meeting; March 25-29, 2022. Abstract/Poster 31288.