Rheumatology (Oxford). 2025 Feb 3:keaf030. doi: 10.1093/rheumatology/keaf030.Online ahead of print.

François Maillet ¹, Yann Nguyen ^2 3, Olivier Espitia ⁴, Laurent Perard ⁵, Carlo Salvarani ⁶, Etienne Rivière ⁷, Dieynaba Ndiaye ⁷, Cécile-Audrey Durel ⁵, Philippe Guilpain ⁸, Luc Mouthon ¹, Anna Kernder ⁸, Javier Loricera ⁹, Pascal Cohen ¹, Isabelle Melki ¹⁰, Claire de Moreuil ¹¹, Nicolas Limal ¹², Arsène Mékinian ¹³, Nathalie Costedoat-Chalumeau ¹, Nathalie Morel ¹, Jonathan Boutemy ¹⁴, Loïc Raffray ¹⁵, Jean-Sébastien Allain ¹⁶, Valérie Devauchelle ¹⁷, Isabelle Kone-Paut ¹⁸, Marc Fabre ¹⁹, Marie Durel ²⁰, Antoine Dossier ²¹, Sébastien Abad ²², Marcella Visentini ²³, Adrien Bigot ²⁴, Halil Yildiz ²⁵, Olivier Fain ¹³, Maxime Samson ²⁶, Guillaume Gondran ²⁷, Vered Abitbol ²⁸, Benjamin Terrier ¹

Author information

¹Department of Internal Medicine, National Referral Center for Systemic and Autoimmune Disease, Cochin University Hospital, AP-HP, Paris, France.

²Department of Internal Medicine, Beaujon University Hospital, AP-HP.Nord, Université Paris Cité, Clichy, France.

³Centre de Recherche en Epidémiologie et Statistiques (CRESS), Unité Inserm 1153, Université de Paris Cité, Paris, France.

⁴Nantes Université, CHU Nantes, Department of Internal and Vascular Medicine, Institut du thorax, INSERM UMR1087/CNRS UMR 6291, Team III Vascular & Pulmonary diseases, Nantes, F-44000, France.

⁵Department of Internal Medicine, Saint Joseph Saint Luc Hospital, Lyon, France.

⁶Division of Rheumatology, Azienda USL-IRCCS di Reggio Emilia and Università di Modena e Reggio Emilia, Reggio Emilia, Italy.

⁷Department of Internal Medicine, Haut-Lévèque University Hospital, Bordeaux, France.

⁸Department of Internal Medicine, Saint-Eloi University Hospital, Montpellier, France.

⁹Rheumatology Division, Hospital Universitario Marqués de Valdecilla, IDIVAL, Immunopathology Group, Valdecilla s/n, Santander, ES- 39008, Spain.

¹⁰Department of Infectious Disease and Internal Medicine, Reference center for Rheumatic, AutoImmune and Systemic diseases in children (RAISE), Robert Debré University Hospital, AP-HP, Paris, France.

¹¹Department of Internal Medicine, Brest University Hospital, Brest, France.

¹²Department of Internal Medicine, Henri Mondor University Hospital, AP-HP, Créteil, France.

¹³Department of Internal Medicine, Saint-Antoine University Hospital, AP-HP, Paris, France.

¹⁴Department of Internal Medicine, Caen University Hospital, Caen, France.

¹⁵Department of Internal Medicine, Saint-Denis University Hospital, Reunion, France.

¹⁶Department of Internal Medicine, Scorff-Lorient Hospital, Lorient, France.

¹⁷Department of Rheumatology, Brest University Hospital, Brest, France.

¹⁸Department of Paediatric Rheumatology and CEREMAIA, ERN RITA member, Bicêtre University Hospital, AP-HP, Paris, France.

¹⁹Department of Internal Medicine, Pierre Oudot Hospital, Bourgoin-Jallieu, France.

²⁰Department of Internal Medicine, Robert Schuman Hospital, Vantoux, France.

²¹Department of Internal Medicine, Bichat University Hospital, AP-HP, Paris, France.

²²Department of Internal Medicine, Avicenne University Hospital, AP-HP, Bobigny, France.

²³Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy.

²⁴Department of Internal Medicine, Tours University Hospital, Tours, France.

²⁵Department of Internal Medicine and Infectious Diseases, Cliniques Universitaires Saint-Luc, Brussels, Belgium.

²⁶Department of Internal Medicine and Clinical Immunology, Dijon University Hospital, Dijon, France.

²⁷Department of Internal Medicine, Limoges University Hospital, Limoges, France.

²⁸Department of Gastroenterology, Cochin University Hospital, Paris, AP-HP.

Abstract

Objectives: To describe the characteristics and outcome of patients with the association of large vessel vasculitis (LVV, Takayasu arteritis [TA] or giant cell arteritis [GCA]) and inflammatory bowel disease (IBD).

Methods: An observational, multicentre, retrospective case-control study. Cases were LVV-IBD patients from European countries, whereas controls had isolated LVV (iLVV).

Results: 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 (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.