Prevalence, timing and risk factors of extraintestinal manifestations in inflammatory bowel disease: a retrospective cohort study from a German tertiary referral center.

Authors

Fotios Fousekis, Panagiotis Garantziotis, André Jefremow, Christina Bergmann, Maria Gabriella Raimondo, Andreas Ramming, Georg Schett, Markus F Neurath, Raja Atreya

Published in

Crohn's & colitis 360. Volume 8. Issue 4. Pages otag100. Epub Sep 02, 2026.

Abstract

Extraintestinal manifestations (EIMs) are a frequent and clinically significant feature of inflammatory bowel disease (IBD), contributing to morbidity and impaired quality of life.
To investigate the prevalence, spectrum, timing, and risk factors of EIMs in a large cohort of patients with IBD.
In this retrospective cohort study, adult patients with ulcerative colitis (UC) or Crohn's disease (CD) followed at a German tertiary referral center were included. Electronic medical records were reviewed to identify specialist-confirmed EIMs, their timing relative to IBD diagnosis, and associated demographic and disease-related factors.
A total of 817 patients with IBD (527 CD, 290 UC) were included, with a median disease duration of 11 years (IQR 6-19). EIMs were identified in 227 patients (27.8%), with rheumatologic (17.4%) and cutaneous (8.9%) manifestations being the most frequent. Most patients had one EIM (70%), while 30% developed multiple manifestations. Female sex (OR 2.88; 95% CI 2.08-4.02, P < .001), longer IBD duration (OR 1.02 per year; 95% CI 1.01-1.04, P = .002), and CD (OR 1.57; 95% CI 1.08-2.29, P = .018) were independently associated with EIM development. EIMs occurred before or concurrently with IBD diagnosis in 20.7% of affected patients. Kaplan-Meier analysis demonstrated a continuous increase in the cumulative probability of developing EIMs over time, reaching approximately 27% at 15 years of follow-up.
EIMs affect more than one quarter of patients with IBD and may precede or coincide with intestinal disease onset. Female sex and CD appear to be independent risk factors. These findings highlight the importance of early recognition and long-term surveillance of EIMs in patients with IBD.

PMID:
42836101
Bibliographic data and abstract were imported from PubMed on 06 Oct 2026.

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