Characteristics of inflammatory bowel diseases in patients with concurrent immune-mediated inflammatory diseases

Abstract

Patients with inflammatory bowel disease (IBD) are more likely to have concurrent immune-mediated inflammatory diseases (IMIDs) than those without IBD. IMIDs have been observed to alter the phenotype and outcomes of IBD in recent studies. Several studies have found that IBD patients with concurrent IMIDs may have more extensive or severe disease phenotypes, and are considered to be at increased risk of requiring biologics and IBD-related surgeries, suggesting that having multiple IMIDs is a poor prognostic factor for IBD. Furthermore, IBD patients with primary sclerosing cholangitis and Takayasu arteritis are reported to have unique endoscopic phenotypes, suggesting concurrent IMIDs can influence IBD phenotype with specific intestinal inflammatory distributions. In this review, we discuss the pathogenesis, disease phenotypes, and clinical outcomes in IBD patients with concomitant IMIDs.

Keywords: Inflammatory bowel disease; Phenotypes; Outcomes; Concurrent immune-mediated inflammatory diseases

Core Tip: Patients with inflammatory bowel disease (IBD) are more likely to acquire other immune-mediated inflammatory diseases (IMIDs). IBD patients with concurrent IMIDs were more likely to require biologics and IBD-related surgeries than non-IBD patients due to extensive disease phenotypes according to recent studies. As a result, when treating IBD patients, we must be aware of the concurrence of other IMIDs and understand its pathogenesis to select biologic and small molecule therapies that treat multiple concomitant diseases.