METHODS: The IBD and Sinusitis Study at UChicago Medicine (TISSUe) is a retrospective, single-center study. We reviewed patients to confirm IBD and chronic sinusitis diagnoses. Case-control propensity score matching was performed using matched controls with IBD only or sinusitis only. Statistical methods included Chi-squared test and Wilcoxon rank sum test. Logistic regression analysis was performed, and factors were considered significant if p<0.05.
RESULTS: Stratifying 214 patients with coexisting IBD and sinusitis, 176 patients had IBD first and 38 patients had sinusitis first. Multivariable analysis of factors associated with subsequent disease with matched controls determined that duration of disease, UC, steroid exposure ever, and younger age of IBD diagnosis were associated with subsequent sinusitis in patients with IBD; steroid exposure ever and duration of sinusitis were significantly associated with subsequent IBD in patients with sinusitis.
CONCLUSIONS: This study suggests that IBD maintenance therapies are not associated with increased risk of sinusitis, as proposed by adverse events in clinical trial data; rather, UC diagnosis and duration of disease may be more influential in sinusitis development. While further studies are necessary, this study also demonstrates that sinusitis precedes IBD in some patients, probing its biological association with IBD and possible classification as an extraintestinal manifestation.
方法:芝加哥医学院的IBD和鼻窦炎研究是一项回顾性研究,单中心研究。我们回顾了患者以确认IBD和慢性鼻窦炎的诊断。使用仅具有IBD或仅具有鼻窦炎的匹配对照进行病例对照倾向评分匹配。统计方法包括卡方检验和Wilcoxon秩和检验。进行Logistic回归分析,和因素被认为是显著的,如果p<0.05。
结果:对214例同时存在IBD和鼻窦炎的患者进行分层,176例患者首先患有IBD,38例患者首先患有鼻窦炎。与随后的疾病相关的因素的多变量分析与匹配的对照确定疾病的持续时间,UC,曾经接触过类固醇,在IBD患者中,较年轻的IBD诊断年龄与随后的鼻窦炎相关;在鼻窦炎患者中,激素暴露史和鼻窦炎持续时间与随后的IBD显著相关.
结论:这项研究表明,IBD维持治疗与鼻窦炎的风险增加无关。如临床试验数据中的不良事件所提出的;相反,UC的诊断和病程可能在鼻窦炎的发展中更有影响。虽然需要进一步的研究,这项研究还表明,在一些患者中,鼻窦炎先于IBD,探讨其与IBD的生物学关联以及可能的肠外表现分类。