Impact of Endometriosis on the Progression of Inflammatory Bowel Diseases: A Multicenter Retrospective Study
Year: 2025
Type: article
Study design: Observational Study
Abstract: INTRODUCTION: Women with endometriosis have a higher risk of developing inflammatory bowel diseases (IBDs). This study aimed to better understanding the impact of endometriosis on the course of IBD. METHODS: We conducted a retrospective cohort study in 18 French and Belgian IBD centers between June 2022 and March 2023. Any patient with both conditions was eligible for inclusion. They were randomly matched to 1 or 2 patients with IBD without endometriosis. The impact on IBD progression was assessed using a composite severity criterion including intestinal damage or need for bowel surgery. RESULTS: Overall, 207 patients with both conditions (149 Crohn's disease [CD]; 58 ulcerative colitis [UC]) were matched to 409 patients with IBD alone. The median follow-up duration for IBD was 10 years (5.75-17). No difference was observed between the 2 groups regarding CD location, disease phenotype, and anoperineal involvement. Proctitis were more frequent in patients with UC and endometriosis. Patients with IBD with endometriosis were significantly less exposed to immunosuppressants (UC P < 0.01; CD P < 0.001) and biologics (UC P < 0.01; CD P < 0.001). Patients with CD with endometriosis had a less severe disease course compared with patients without endometriosis (hazard ratio 0.68, 95% confidence interval 0.50-0.92, P = 0.011). Patients with UC with endometriosis had not a significant different disease course compared with patients without endometriosis (hazard ratio 1.73, 95% confidence interval 0.74-4.00, P = 0.20). These results were similar in the subgroup of patients with endometriosis treated surgically. DISCUSSION: Endometriosis does not negatively influence the course of IBD, patients with CD even have a less severe progression. Patients were significantly less exposed to immunosuppressants and biologics.
Authors: Lucas Guillo, Oumaya El Oumami, Philippe Seksik, Guillaume Le Cosquer, Louise Méheut, Vered Abitbol, Stéphane Nancey, Anthony Buisson, Mathieu Uzzan, Mathias Vidon, Ludovic Caillo, Bénédicte Caron, Alban Benezech, Calina Atanasiu, Nicolas Richard, Alexandre Nuzzo, Catherine Le Berre, Anne Bourrier, Catherine Reenaers, Julien Labreuche, Mélanie Serrero, Chrystèle Rubod, Pauline Wils
Institutions: Aix-Marseille Université, Hôpital Nord, Université de Lille, Centre Hospitalier Universitaire de Lille, Hôpital Claude Huriez, Inserm, Sorbonne Université, Hôpital Saint-Antoine, Centre de Recherche Saint-Antoine, Centre Hospitalier Universitaire de Toulouse, Sorbonne Paris Cité, Hôpital Cochin, Université Paris Descartes, Hospices Civils de Lyon, Hôpital Lyon Sud, Centre International de Recherche en Infectiologie, Université Clermont Auvergne, Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement, Microbe, Intestine, Inflammation and Host Susceptibility, Centre Hospitalier Universitaire de Clermont-Ferrand, Université Paris-Est Créteil, Centre Hospitalier Universitaire Henri-Mondor, Assistance Publique – Hôpitaux de Paris, Hôpitaux Universitaires Henri-Mondor, Hôpital Albert-Chenevier, Early detection of Colon Cancer using Molecular Markers and Microbiota, Hôpital Européen Georges-Pompidou, Centre Hospitalier Universitaire de Nîmes, Université de Nîmes, Centre Hospitalier Régional et Universitaire de Nancy, Nutrition-Génétique et Exposition aux Risques Environnementaux, Université de Lorraine, Hôpital Paris Saint-Joseph, Centre Hospitalier Universitaire de Rouen, Hôpital Beaujon, Laboratoire de Recherche Vasculaire Translationnelle, Centre Hospitalier Universitaire de Nantes, Centre d'Investigation Clinique de Nantes, Nantes Université, Centre Hospitalier Universitaire de Liège, Evaluation des technologies de santé et des pratiques médicales, Institute for Translational Research in Inflammation
Language: English
Subfield: Reproductive Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,800
OpenAlex ID: W4417183689
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