Association between Crohn's disease and pulmonary nodule patterns: an inverse probability-weighted analysis of real-world data.

Authors

Changsheng Cai, He Gu, Chunyan Li, Jie Liang, Feng Tian, Xiaocang Cao, Yue Li, Yubei Gu, Wenbin Qin, Qi Feng, Jun Shen, Mimic Inflammatory Bowel Disease Study Group

Published in

Clinical and translational gastroenterology. Oct 08, 2026. Epub Oct 08, 2026.

Abstract

Crohn's disease (CD) is a systemic inflammatory disorder with potential pulmonary involvement; however, its association with pulmonary nodules and how disease phenotype, medication, and inflammation affect nodule characteristics are unclear. Using real-world data, we aimed to comprehensively assess the burden of pulmonary nodules among patients with CD, characterize their longitudinal dynamic trajectories, and identify key determinants of their imaging phenotypes.
In this retrospective multicenter cohort study of 2,009 patients with CD and 4,002 controls, we used inverse probability weighting (IPW) to compare the nodule burden and its dynamics over time in a longitudinal subcohort (n = 2,956). We assessed the associations of the Montreal classification, biologics, corticosteroids, C-reactive protein, and extraintestinal manifestations with nodule features among patients with CD and explored risk factors for high-risk nodules related to CD.
CD was associated with higher nodule counts across all subtypes (e.g., solid nodules: incidence rate ratio [IRR], 1.80; 95% confidence interval [CI], 1.62-1.98; P < 0.001). Longitudinally, compared with controls, patients with CD experienced greater reductions in solid nodules and nodules <6 mm (P < 0.001) despite the slightly faster growth of persistent nodules <6 mm. Disease phenotypes and extraintestinal manifestations were not associated with nodule features. Age was an independent predictor and the strongest predictor of the pulmonary nodule burden. Adalimumab was correlated with fewer non-solid and 6- to 8-mm nodules (IRR, 0.615-0.676; P < 0.01). CD-related clinical factors had limited utility for predicting high-risk nodules.
CD confers an increased pulmonary nodule burden with a unique dynamic evolution. Risk stratification should prioritize age and medication exposures instead of disease phenotype because phenotypic markers lack predictive value for nodule outcomes.

PMID:
42848322
Bibliographic data and abstract were imported from PubMed on 09 Oct 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.