Association between large vessel vasculitis and inflammatory bowel disease: a case-control study.
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Maillet François, Nguyen Yann, Espitia Olivier, Perard Laurent, Salvarani Carlo, Rivière Etienne, Ndiaye Dieynaba, Durel Cécile-Audrey, Guilpain Philippe, Mouthon Luc, Kernder Anna, Loricera Javier, Cohen Pascal, Melki Isabelle, de Moreuil Claire, Limal Nicolas, Mékinian Arsène, Costedoat-Chalumeau Nathalie, Morel Nathalie, Boutemy Jonathan, Raffray Loïc, Allain Jean-Sébastien, Devauchelle Valérie, Kone-Paut Isabelle, Fabre Marc, Durel Marie, Dossier Antoine, Abad Sébastien, Visentini Marcella, Bigot Adrien, Yildiz Halil, Fain Olivier, Samson Maxime, Gondran Guillaume, Abitbol Vered, Terrier Benjamin
Аннотация
METHODS: An observational, multicentre, retrospective case-control study. Cases were LVV-IBD patients from European countries, whereas controls had isolated LVV (iLVV).
RESULTS: A total of 39 TA-IBD and 12 GCA-IBD cases were enrolled, compared with 52 isolated GCA (iGCA) and 93 isolated TA (iTA) controls. LVV occurred after IBD in 56% in TA-IBD and 75% in GCA-IBD, with a median interval of 1 year (interquartile range [IQR] 1-7) in TA-IBD and 8.6 years (IQR 1-17.7) in GCA-IBD. Crohn's disease was more common in TA-IBD (67%), whereas ulcerative colitis was more common in GCA-IBD (58%). Compared with iTA, TA-IBD were significantly younger at diagnosis of TA (median age 27 vs 37 years, P < 0.001) and had more upper limb claudication (36% vs 12%, P = 0.006). GCA-IBD patients had more frequent arterial thickening or stenosis than controls (75% vs 30%, respectively, P = 0.044) and tended to more frequently involve gastrointestinal arteries (20% vs 0%, respectively, P = 0.06). LVV occurred in IBD patients despite treatment with glucocorticoids (36%), azathioprine (25%) or TNF-alpha blockers (29%). The presence of the IBD was not associated with a higher LVV relapse rate in multivariate analysis (adjusted hazard ratio [aHR] 0.62 [0.13-2.83] for GCA and aHR 0.92 [0.44-1.89] for TA).
CONCLUSION: This study identifies specific clinical and imaging characteristics of LVV-IBD patients, in particular a more severe vascular presentation of GCA-IBD patients compared with iGCA patients.