The Impact of Hormone Therapy on Inflammatory Bowel Disease in Transgender and Nonbinary Individuals.

IF 4.5 3区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Inflammatory Bowel Diseases Pub Date : 2024-10-16 DOI:10.1093/ibd/izae236

Bashar Hassan, Andrew Suchan, Madyson Brown, Arman Kishan, Fan Liang, Brindusa Truta

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引用次数: 0

Abstract

Background: Inflammatory bowel disease (IBD) is a global healthcare problem that affects around 3 million people in the United States. Although the impact of gender-affirming hormone therapy (GAHT) on IBD severity has been studied in cisgender patients, there is currently no literature on the impact of exogenous hormone therapy (HT) in transgender and nonbinary (TGNB) individuals.

Methods: We conducted a retrospective chart review of TGNB adults diagnosed with IBD and treated with HT for gender dysphoria at Johns Hopkins Hospital (2015-2022). We aimed to determine whether the use of GAHT was associated with subsequent increase in IBD severity. We compared the incidence of flares before vs after GAHT.

Results: Twenty-two patients were analyzed. More than half (59%) of them were assigned female at birth, identified as transmen, and underwent masculinizing HT. Their median (interquartile range) age was 30 (25-36) years. More patients had Crohn's disease compared with ulcerative colitis (13 [59.1%] vs 9 [40.9%], P = .23) with a median IBD duration of 6.2 (1.8-12.3) years. Nine (41%) patients were on biologics. Of 15 patients on HT, 8 (36.3%) experienced at least one flare. Most of them were treated with steroids (66.7%), and 6 (40%) required hospital or emergency room admission. The proportion of patients who flared after GAHT was similar to that before GAHT: 9 (60%) vs 8 (53.3%), P = 1.0.

Conclusions: GAHT was not associated with increased incidence of flares. Larger prospective randomized studies are needed to confirm our findings and understand the interaction between GAHT and IBD in TGNB individuals.

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激素疗法对变性人和非二元个体炎症性肠病的影响。

背景：炎症性肠病（IBD）是一个全球性的医疗保健问题，影响着美国约 300 万人。尽管对顺性患者进行了性别确认激素疗法（GAHT）对 IBD 严重性影响的研究，但目前还没有关于外源性激素疗法（HT）对变性和非二元性（TGNB）个体影响的文献：我们对约翰斯-霍普金斯医院（2015-2022 年）确诊为 IBD 并接受 HT 治疗的 TGNB 成人进行了回顾性病历审查。我们旨在确定使用 GAHT 是否与随后 IBD 严重程度的增加有关。我们比较了GAHT治疗前后复发的发生率：对 22 名患者进行了分析。其中一半以上（59%）的患者在出生时被分配为女性，被确认为跨性别者，并接受了男性化 HT 治疗。他们的中位数（四分位数间距）年龄为 30（25-36）岁。与溃疡性结肠炎相比，更多患者患有克罗恩病（13 [59.1%] 对 9 [40.9%]，P = .23），中位 IBD 病程为 6.2 (1.8-12.3) 年。9名患者（41%）正在使用生物制剂。在 15 名接受 HT 治疗的患者中，8 人（36.3%）至少出现过一次复发。其中大多数人接受了类固醇治疗（66.7%），6 人（40%）需要入院或急诊。GAHT后复发的患者比例与GAHT前相似：9（60%）对8（53.3%），P = 1.0：GAHT与复发率增加无关。需要更大规模的前瞻性随机研究来证实我们的发现，并了解 GAHT 与 TGNB 患者 IBD 之间的相互作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Inflammatory Bowel Diseases 医学-胃肠肝病学

CiteScore

9.70

自引率

6.10%

发文量

462

审稿时长

1 months

期刊介绍： Inflammatory Bowel Diseases® supports the mission of the Crohn''s & Colitis Foundation by bringing the most impactful and cutting edge clinical topics and research findings related to inflammatory bowel diseases to clinicians and researchers working in IBD and related fields. The Journal is committed to publishing on innovative topics that influence the future of clinical care, treatment, and research.