The Prevalence of Asthma Are Increased in Inflammatory Bowel Disease, but Decreased After Biologics Treatment: A Population-Based Study

Introduction: Inflammatory bowel disease (IBD) patients exhibit higher association with asthma. IBD and asthma are both immune-mediated disorders. Also, they share genetic and environmental factors. Previous studies suggested that initiation of biologics could achieve remission of asthma. However, data is limited in IBD. We sought to investigate the prevalence of asthma in IBD patients with and without biologics. Methods: We used a commercial database (Explorys Inc, Cleveland, OH) which includes electronic health record data from 26 major integrated US healthcare systems. Based on Systematized Nomenclature Of Medicine – Clinical Terms (SNOMED-CT), we identified all patients (age >18 years) who were diagnosed with either CD or UC between 1999 and 2022 who were treated with any type of biologics. We investigated the prevalence of asthma in IBD patients compared to patients with no IBD. Also, we compared the prevalence between IBD patients with and without biologics therapy. Results: Of the 70,040,480 individuals in the database, we identified 249,480 (0.4%) patients with CD and 209,020 (0.3%) patients with UC, of whom 44,930 (18%) and 23,040 (11%) patients received biologics therapy, respectively. The prevalence of asthma was 21% for each CD and UC, compared to 7% in individuals without IBD, p< 0.0001 to all. The prevalence of asthma was significantly lower in biologics treated CD patients (16%) compared to those who did not receive biologics (22%) (Figure). Similarly, biologics treated UC patients were significantly less likely to have asthma (16%) compared to UC patients who did not receive biologics therapy (21%), p< 0.0001to all (Figure). Conclusion: This is the largest individual study investigating prevalence of asthma in patients with IBD with and without biologics therapy. We found that IBD patients who were treated with biologics were significantly less likely to have asthma when compared to IBD individuals who were never treated with biologics.Figure 1.: The Effect of Biologics in Patients with Asthma and Inflammatory Bowel Disease.