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Quantifying risk factors for microscopic colitis: A nationwide, retrospective cohort study
Abdul Mohammed1, Sara Ghoneim2, Neethi Paranji1
1Division of Gastroenterology and Hepatology, MetroHealth Medical Center, 2500 MetroHealth Drive, Cleveland, OH, 44109, USA.
Background:
Microscopic colitis (MC) is associated with several risk factors; however, their relative risk has been variable and not thoroughly evaluated. We aimed to quantify the risk of medical comorbidities and medications associated with MC and treatment offered to these patients.
Methods:
A population-based retrospective analysis in International Business Machines (IBM) Explorys (1999-2018), a pooled, de-identified database of 63 million patients in the USA, was performed. Odds ratios (OR) were calculated between MC and other diseases/medications. MC patients were also stratified by age to assess trends of MC in different age groups.
Results:
A total of 1130 patients had MC in the database. Among medications, non-steroidal anti-inflammatory agents (OR, 20.2) and proton pump inhibitors (OR, 12.1) were associated with highest odds of MC. Among medical comorbidities, infectious gastroenteritis (OR, 26.6) and celiac disease (OR, 22.5) had the highest odds of being associated with MC. Tobacco smoking, psoriasis, Sjogren's syndrome, Clostridium difficile infection, and malabsorption syndromes all conferred odds greater than 10.
Conclusion:
Early identification of MC is critical for minimizing morbidity and mortality. Epidemiologic information can be integrated with current clinical algorithms to more rapidly identify patients at risk.
Insights
Non-steroidal anti-inflammatory agents and proton pump inhibitors are strongly linked to microscopic colitis (MC). Infectious gastroenteritis and celiac disease also significantly increase MC risk, aiding early patient identification.
Area of Science:
- Gastroenterology
- Epidemiology
- Pharmacology
Background:
- Microscopic colitis (MC) has known risk factors, but their precise relative risks require thorough evaluation.
- Understanding these associations is crucial for managing MC morbidity and mortality.
Purpose of the Study:
- To quantify the risk of medical comorbidities and medications associated with microscopic colitis (MC).
- To evaluate the risk of treatments offered to patients diagnosed with MC.
Main Methods:
- Population-based retrospective analysis of the IBM Explorys database (1999-2018) involving 63 million patients.
- Calculation of odds ratios (OR) to determine associations between MC and diseases/medications.
- Stratification of MC patients by age to identify demographic trends.
Main Results:
- Non-steroidal anti-inflammatory agents (OR, 20.2) and proton pump inhibitors (OR, 12.1) showed the highest odds of association with MC.
- Infectious gastroenteritis (OR, 26.6) and celiac disease (OR, 22.5) were strongly linked to MC.
- Tobacco smoking, psoriasis, Sjogren's syndrome, Clostridium difficile infection, and malabsorption syndromes also conferred high odds (>10) of MC association.
Conclusions:
- Early identification of MC is critical for reducing patient morbidity and mortality.
- Integrating epidemiologic data with clinical algorithms can accelerate the identification of at-risk individuals.
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