P1168 - Higher Frequency of Respiratory Symptoms Are Reported Among Patients With Crohn’s Disease Compared to Patients With Ulcerative Colitis

Tatini Mal-Sarkar, MD¹, Suruchi Ramanujan, MD², Varisha Essani, MD³, Joseph Sleiman, MD⁴, Suha Abushamma, MD⁴, Taha Qazi, MD⁴, Florian Rieder, MD⁴, Katherine Falloon, MD⁴
1Cleveland Clinic Foundation, Cleveland Heights, OH; 2University of California San Diego, San Diego, CA; 3University of Toledo Medical Center, Toledo, OH; 4Cleveland Clinic Foundation, Cleveland, OH

Introduction: 30-50% of patients with inflammatory bowel disease (IBD) present with extraintestinal manifestations (EIMs). Thus far, pulmonary manifestations of IBD have been underexplored. This study investigates the clinical presentation of pulmonary EIMs by comparing respiratory symptom presentation between individuals with Crohn’s disease (CD) and those with ulcerative colitis (UC).

Methods: We performed a systematic review and meta-analysis of studies that reported respiratory symptoms in adult patients with IBD. We included cohort, randomized control trial, cross-sectional, and case-control study designs. This included nine cohort studies, two cross-sectional studies, and five case- control studies. Primary outcomes such as respiratory symptoms, cough, wheezing, and dyspnea were compared between patients with CD and patients with UC. Chi-square analysis was performed to compare prevalence of symptoms across groups. Percentages were calculated out of the total number of patients in studies that reported each symptom.

Results: 8132 patients with IBD were included in this study, including 795 (9.8%) patients with CD and 7337 (90.2%) patients with UC. Because controls were selected for their healthiness, they were not included in this analysis. Patients with CD were significantly more likely to report respiratory symptoms (Table 1) – over 30 percent of patients with CD endorsed respiratory symptoms, compared to 9.8 percent of patients with UC (p < 0.0001). Patients with CD were more likely to report any cough (135 (21.7%) vs 205 (14.9%), p = 0.0002) and dyspnea (111 (19.1%) vs 432 (6.8%), p < 0.0001). Patients with UC were more likely to report wheezing (49 (29.7%) vs 63 (19.5%), p = 0.0113). No significant differences were noted between diagnoses when cough was disaggregated by nonproductive vs productive (p = 0.47 and p = 0.09 respectively).

Discussion: Patients with CD are more likely to experience respiratory symptoms than patients with UC, particularly cough and dyspnea. However, both groups experience respiratory symptoms although their symptom profiles may differ. Providers taking care of patients with IBD should inquire about respiratory symptoms and consider further work-up if present.


Figure: Title: Table 1: Summary of Respiratory Symptoms in IBD Patients and Controls By Diagnosis
Caption: CD: Crohn’s Disease; IBD: Inflammatory Bowel Disease; IBDU: Inflammatory Bowel Disease, subtype unspecified; NA: Not Applicable; UC: Ulcerative Colitis; *p < 0.05 compared between IBD diagnosis

Disclosures:
Tatini Mal-Sarkar indicated no relevant financial relationships.
Suruchi Ramanujan indicated no relevant financial relationships.
Varisha Essani indicated no relevant financial relationships.
Joseph Sleiman indicated no relevant financial relationships.
Suha Abushamma indicated no relevant financial relationships.
Taha Qazi: Abbvie – Advisor or Review Panel Member, Advisory Committee/Board Member, Consultant, Grant/Research Support, Speakers Bureau. Celltirion – Grant/Research Support. Eli Lilly – Advisor or Review Panel Member, Advisory Committee/Board Member, Consultant. Johnson and Johnson – Advisor or Review Panel Member, Advisory Committee/Board Member, Consultant, Speakers Bureau. pfizer – Grant/Research Support.
Florian Rieder: Adiso – Advisory Committee/Board Member, Consultant. Adnovate, Agomab, Allergan, AbbVie, Arena, Astra Zeneca, Bausch & Lomb, Boehringer-Ingelheim, Celgene/BMS, Celltrion, CDISC, Celsius, Cowen, 89Bio – Advisory Committee/Board Member, Consultant. Eugit, Ferring, Galapagos, Galmed, Genentech, Gilead, Gossamer, Granite, Guidepoint, Helmsley, Horizon Therapeutics, Image Analysis Limited – Advisory Committee/Board Member, Consultant. Landos, Jannsen, Koutif, Mestag, Metacrine, Mirum, Mobius, Mopac, Morphic, Myka Labs, Organovo, Origo, Palisade, Pfizer, Pliant, Prometheus Bioscience – Advisory Committee/Board Member, Consultant. Receptos, RedX, Roche, Samsung, Sanofi, Surmodics, Surrozen, Takeda, Techlab, Teva, Theravance, Thetis, Tr1x Bio, UCB, Ysios – Advisory Committee/Board Member, Consultant.
Katherine Falloon: Cardinal Health, Inc. – Husband is employee. Janssen Pharmaceuticals, Inc. – Consultant. MD Education – Speaker. Pfizer – Grant/Research Support. Takeda Pharmaceuticals, Inc. – Speaker.

Tatini Mal-Sarkar, MD¹, Suruchi Ramanujan, MD², Varisha Essani, MD³, Joseph Sleiman, MD⁴, Suha Abushamma, MD⁴, Taha Qazi, MD⁴, Florian Rieder, MD⁴, Katherine Falloon, MD⁴. P1168 - Higher Frequency of Respiratory Symptoms Are Reported Among Patients With Crohn’s Disease Compared to Patients With Ulcerative Colitis, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.