Association between large vessel vasculitis and inflammatory bowel disease: a case-control study.
(2025) Rheumatology (Print) — Vol. 64, n° 6, p. 3724-3732 (2025)
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- Authors
Maillet, François 
Nguyen, Yann Espitia, Olivier Terrier, Benjamin
- Abstract
- OBJECTIVES: To describe the characteristics and outcome of patients with the association of large vessel vasculitis (LVV, Takayasu arteritis [TA] or GCA) and IBD. METHODS: An observational, multicentre, retrospective case-control study. Cases were LVV-IBD patients from European countries, whereas controls had isolated LVV (iLVV). RESULTS: A total of 39 TA-IBD and 12 GCA-IBD cases were enrolled, compared with 52 isolated GCA (iGCA) and 93 isolated TA (iTA) controls. LVV occurred after IBD in 56% in TA-IBD and 75% in GCA-IBD, with a median interval of 1 year (interquartile range [IQR] 1-7) in TA-IBD and 8.6 years (IQR 1-17.7) in GCA-IBD. Crohn's disease was more common in TA-IBD (67%), whereas ulcerative colitis was more common in GCA-IBD (58%). Compared with iTA, TA-IBD were significantly younger at diagnosis of TA (median age 27 vs 37 years, P < 0.001) and had more upper limb claudication (36% vs 12%, P = 0.006). GCA-IBD patients had more frequent arterial thickening or stenosis than controls (75% vs 30%, respectively, P = 0.044) and tended to more frequently involve gastrointestinal arteries (20% vs 0%, respectively, P = 0.06). LVV occurred in IBD patients despite treatment with glucocorticoids (36%), azathioprine (25%) or TNF-alpha blockers (29%). The presence of the IBD was not associated with a higher LVV relapse rate in multivariate analysis (adjusted hazard ratio [aHR] 0.62 [0.13-2.83] for GCA and aHR 0.92 [0.44-1.89] for TA). CONCLUSION: This study identifies specific clinical and imaging characteristics of LVV-IBD patients, in particular a more severe vascular presentation of GCA-IBD patients compared with iGCA patients.
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Citations
Maillet, F., Nguyen, Y., Espitia, O., Perard, L., Salvarani, C., Rivière, E., Ndiaye, D., Durel, C.-A., Guilpain, P., Mouthon, L., Kernder, A., Loricera, J., Cohen, P., Melki, I., de Moreuil, C., Limal, N., Mékinian, A., Costedoat-Chalumeau, N., Morel, N., et al. (2025). Association between large vessel vasculitis and inflammatory bowel disease: a case-control study. Rheumatology (Print), 64(6), 3724-3732. https://doi.org/10.1093/rheumatology/keaf030 (Original work published 2025)