P3275 - Systemic Vasculitis Patterns Among Hospitalized Patients With Inflammatory Bowel Disease in the United States

Wael T. Mohamed, MD¹, Mohamed A. Omar, MD¹, David Maundu, MD¹, Nathan Tofteland, MD¹, Jana G. Hashash, MD, MSc, FACG², Francis A.. Farraye, MD, MSc, MACG²
1University of Kansas School of Medicine, Wichita, KS; 2Mayo Clinic, Jacksonville, FL

Introduction: Inflammatory bowel disease (IBD) is associated with extraintestinal manifestations, but the association with systemic vasculitides remains poorly defined. This study aims to evaluate the prevalence of systemic vasculitis in hospitalized patients with Crohn’s disease (CD) and ulcerative colitis (UC), compared to non-IBD admissions.

Methods: We analyzed 2018–2022 data from the National Inpatient Sample, identifying hospitalizations with systemic vasculitides using ICD-10 codes (including Takayasu arteritis, granulomatosis with polyangiitis [GPA], eosinophilic granulomatosis with polyangiitis, microscopic polyangiitis, giant cell arteritis, polyarteritis nodosa, cryoglobulinemia, and hypersensitivity vasculitis). CD and UC were identified as secondary diagnoses. Weighted cross-tabulations were used to estimate prevalence. Multivariable Poisson regression was performed to calculate adjusted prevalence ratios (APRs), adjusting for demographic and clinical covariates. Analyses were conducted using STATA v18.

Results: Systemic vasculitis was rare overall, but more frequent among patients with IBD: 0.224% in UC, 0.153% in CD, vs. 0.124% in non-IBD admissions (p< 0.001). After adjustment, UC hospitalizations had a 37% higher vasculitis prevalence than CD (APR 1.37; 95% CI: 1.15–1.63). Increased vasculitis prevalence was independently associated with female sex (APR 1.36), Black race (APR 2.20), and age >65 years (APR 2.80). In contrast, Medicaid insurance and smoking were associated with lower odds of vasculitis (APR 0.49 and 0.81, respectively).
GPA and Takayasu arteritis accounted for the majority of vasculitis cases: GPA affected 0.064% of UC and 0.040% of CD discharges (p< 0.001), while Takayasu arteritis was noted in 0.015% of CD and 0.013% of UC admissions vs. 0.004% in non-IBD admissions (p< 0.001). Other vasculitides were present in < 0.01% of cases without significant differences.

Discussion: Systemic vasculitides are uncommon but significantly more prevalent among hospitalized patients with IBD, particularly those with UC. Female sex, Black race, and older age are associated with increased risk. GPA and Takayasu arteritis represent the most common vasculitic conditions in this population. Further studies are warranted to elucidate underlying mechanisms and implications for IBD management.

Disclosures:
Wael Mohamed indicated no relevant financial relationships.
Mohamed Omar indicated no relevant financial relationships.
David Maundu indicated no relevant financial relationships.
Nathan Tofteland indicated no relevant financial relationships.
Jana Hashash: BMS – Ad Board.
Francis Farraye: Astellas – Advisory Committee/Board Member. Avalo – Advisory Committee/Board Member. Bausch – Advisory Committee/Board Member. BMS – Advisory Committee/Board Member. Braintree Labs – Advisory Committee/Board Member. Fresenius Kabi – Advisory Committee/Board Member. GI Reviewers – Independent Contractor. IBD Educational Group – Independent Contractor. Iterative Health – Advisory Committee/Board Member, Stock Options. Janssen – Advisory Committee/Board Member. Lilly – DSMB. Pfizer – Advisory Committee/Board Member. Pharmacosmos – Advisory Committee/Board Member. Sandoz – Advisory Committee/Board Member. Viatris – Advisory Committee/Board Member.

Wael T. Mohamed, MD¹, Mohamed A. Omar, MD¹, David Maundu, MD¹, Nathan Tofteland, MD¹, Jana G. Hashash, MD, MSc, FACG², Francis A.. Farraye, MD, MSc, MACG². P3275 - Systemic Vasculitis Patterns Among Hospitalized Patients With Inflammatory Bowel Disease in the United States, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.