In the Journals

Patients with hidradenitis suppurativa at greater risk for IBD

Physicians should inform patients with hidradenitis suppurativa about an increased risk for inflammatory bowel disease, according to research in JAMA Dermatology.

“There is an urgent need for the generation of new knowledge to advance the field and improve care of patients with HS,” Haley B. Naik, MD, MHSc, at the department of dermatology at the University of California, San Francisco, and Michelle A. Lowes, MBBS, PhD, at Rockefeller University, New York, wrote in an accompanying editorial.

The study researchers used a literature search to examine the risk for IBD in patients with hidradenitis suppurativa (HS) and identified the odds ratios and hazard ratios of IBD, Crohn disease and ulcerative colitis in association with HS. Five case control studies, two cross-sectional studies and one cohort study were included, with 93,601 unique study participants.

The researchers found significantly increased odds of Crohn disease in patients with HS (OR = 2.12; 95% CI, 1.46-3.08) from a pool of five studies and 91,917 study participants.

In ulcerative colitis, they found significantly increased odds in those with HS (OR = 1.51; 95% CI, 1.25-1.82) from four studies with 39,497 study participants.

They also identified significantly increased odds of IBD in those with HS in two studies with 1,642 study participants (OR = 2.16; 95% CI, 1.40-3.34 and OR = 10.00; 95% CI, 1.94-51.50). From the cohort study with 14,136 study participants, researchers found an increased risk for IBD in those with HS (P < .002, HR = 5.6; 95% CI).

Genetic susceptibility may play a part, according to researchers, with certain genes associated with HS and IBD.

“Altered microbiota with dysregulated immune responses may play an important role in HS and IBD,” Wei-Ti Chen, MD, and Ching-Chi Chi, MD, MMS, DPhil, both at the department of dermatology at Chang Gung Memorial Hospital, Taoyuan, Taiwan, wrote.

Most of the studies were from Western countries and only one study was from Asia, which the researchers qualified as a study limitation.

In the editorial, Naik and Lowes said that prospective clinical studies to identify prognostic factors, phenotype heterogeneity and long-term outcomes are needed to improve the understanding of HS.

Additionally, the multi-institutional Hidradenitis Suppurativa Prospective Observational Registry and Biospecimen Repository has been developed to address this need, they wrote.

“Now that we are beginning to understand the true and tremendous impact of HS in terms of prevalence, quality of life impairment and comorbidity burden, we must extend our knowledge to understand how to best care for patients,” Naik and Lowes wrote. – by Abigail Sutton

 

Disclosures: Chen and Chi report no relevant financial disclosures. Lowes reports she has received fees for participating in advisory boards for AbbVie and Janssen and consulting fees from Incyte, BSN and XBiotech, and Almirall, outside the present study. Naik reports she has received grant support from AbbVie and consulting fees from 23andMe, outside the present study. Lowes and Naik report they are Hidradenitis Suppurativa Foundation board members.

Physicians should inform patients with hidradenitis suppurativa about an increased risk for inflammatory bowel disease, according to research in JAMA Dermatology.

“There is an urgent need for the generation of new knowledge to advance the field and improve care of patients with HS,” Haley B. Naik, MD, MHSc, at the department of dermatology at the University of California, San Francisco, and Michelle A. Lowes, MBBS, PhD, at Rockefeller University, New York, wrote in an accompanying editorial.

The study researchers used a literature search to examine the risk for IBD in patients with hidradenitis suppurativa (HS) and identified the odds ratios and hazard ratios of IBD, Crohn disease and ulcerative colitis in association with HS. Five case control studies, two cross-sectional studies and one cohort study were included, with 93,601 unique study participants.

The researchers found significantly increased odds of Crohn disease in patients with HS (OR = 2.12; 95% CI, 1.46-3.08) from a pool of five studies and 91,917 study participants.

In ulcerative colitis, they found significantly increased odds in those with HS (OR = 1.51; 95% CI, 1.25-1.82) from four studies with 39,497 study participants.

They also identified significantly increased odds of IBD in those with HS in two studies with 1,642 study participants (OR = 2.16; 95% CI, 1.40-3.34 and OR = 10.00; 95% CI, 1.94-51.50). From the cohort study with 14,136 study participants, researchers found an increased risk for IBD in those with HS (P < .002, HR = 5.6; 95% CI).

Genetic susceptibility may play a part, according to researchers, with certain genes associated with HS and IBD.

“Altered microbiota with dysregulated immune responses may play an important role in HS and IBD,” Wei-Ti Chen, MD, and Ching-Chi Chi, MD, MMS, DPhil, both at the department of dermatology at Chang Gung Memorial Hospital, Taoyuan, Taiwan, wrote.

Most of the studies were from Western countries and only one study was from Asia, which the researchers qualified as a study limitation.

In the editorial, Naik and Lowes said that prospective clinical studies to identify prognostic factors, phenotype heterogeneity and long-term outcomes are needed to improve the understanding of HS.

Additionally, the multi-institutional Hidradenitis Suppurativa Prospective Observational Registry and Biospecimen Repository has been developed to address this need, they wrote.

“Now that we are beginning to understand the true and tremendous impact of HS in terms of prevalence, quality of life impairment and comorbidity burden, we must extend our knowledge to understand how to best care for patients,” Naik and Lowes wrote. – by Abigail Sutton

 

Disclosures: Chen and Chi report no relevant financial disclosures. Lowes reports she has received fees for participating in advisory boards for AbbVie and Janssen and consulting fees from Incyte, BSN and XBiotech, and Almirall, outside the present study. Naik reports she has received grant support from AbbVie and consulting fees from 23andMe, outside the present study. Lowes and Naik report they are Hidradenitis Suppurativa Foundation board members.