Abstract Background Patients with inflammatory bowel disease (IBD) frequently exhibit concomitant immune-mediated inflammatory diseases (IMIDs). The coexistence of IBD and IMIDs appears to be associated with a more severe IBD course. However, it remains unclear whether a family history of IMIDs, in the absence of a personal diagnosis, is similarly linked to worse outcomes. This study aimed to assess the prevalence of IMIDs and family history of IMIDs among patients with IBD, and to evaluate their association with major clinical outcomes, such as hospitalization and surgery. Methods We conducted a prospective, multicenter, observational study involving consecutive outpatients attending four IBD referral centers. Data were collected through ad-hoc questionnaire and review of medical records. Adults (≥18 years) with a confirmed diagnosis of IBD for at least 6 months were included. Associations between IMIDs (or family history of IMIDs) and clinical outcomes were assessed using chi-square tests and multivariable logistic regression models adjusting for relevant confounders. Odds ratios (ORs) with 95% confidence intervals (CIs) were reported; p-values 0.05 were considered statistically significant. Results We enrolled 1.009 patients: 543 with ulcerative colitis (UC), 466 with Crohn’s disease (CD). Coexisting IMIDs were identified in 272 patients (27%), more commonly in those with CD (152 patients, 32,6%) than in UC (120 patients, 22%). The most reported IMIDs were psoriasis (6.2%), axial spondyloarthritis (5.5%) and peripheral spondyloarthritis (3.9%). Patients with both IBD and IMIDs had a significantly higher risk of hospitalization compared to those without IMIDs (OR 2.77; 95% CI: 2.00–3.85). The presence of IMIDs was also associated with a greater risk of surgery in patients with CD (OR 1.99; 95% CI: 1.31–3.03) and UC as well (OR 3.87; 95% CI: 1.97–7.71). A family history of IMIDs without a personal diagnosis was reported in 182 patients (18%): 96 UC (17,7%), 86 CD (18,5%). In this subgroup, we observed a non-significant trend toward increased hospitalization (OR 1.49; 95% CI: 1.00–2.22). Notably, CD patients with a positive family history showed a significantly higher risk of surgery (OR 2.24; 95% CI: 1.35–3.72). Conclusion The presence of IMIDs in IBD patients was associated with higher risk of hospitalization and surgery. A positive family history of IMIDs, even in the absence of personal comorbidity, was also linked to a higher surgical risk and a trend toward more hospitalizations. These findings suggest that family history for IMIDs may represent an additional risk factor for adverse IBD outcomes, with potential implications for clinical monitoring and treatment decisions. Conflict of interest: Bezzio, Cristina: No conflict of interest De Bernardi, Alice: No conflict of interest Scalvini, Davide: No conflict of interest Vernero, Marta: No conflict of interest Ribaldone, Davide Giuseppe: No conflict of interest Armuzzi, Alessandro: No conflict of interest Masoni, Benedetta: No conflict of interest Bertani, Lorenzo: No conflict of interest Brinch, Daniele: No conflict of interest Cicalini, Carolina: No conflict of interest Muscia, Roberta: No conflict of interest Arena, Ilaria: No conflict of interest Saibeni, Simone: No conflict of interest
Bezzio et al. (Thu,) studied this question.