IBD patients at increased risk of COPD, asthma

Individuals with inflammatory bowel disease (IBD) appear to be at greater risk of developing chronic obstructive pulmonary disease (COPD) and asthma, suggests a study.

“[W]e found suggestive evidence for the increased risk of incident COPD or asthma among people with IBD compared with the general population,” the investigators said. “Consistent positive associations of Crohn's disease (CD) and ulcerative colitis (UC) with COPD and asthma were observed.”

A total of 430,414 participants from the UK Biobank were included in the analysis and were followed from recruitment (2006­‒2010) to 2021. COPD and asthma cases were identified using inpatient data and death register.

The investigators used Cox proportional hazards models to calculate the multivariable-adjusted hazard ratios (HR) of developing COPD and asthma in participants with IBD relative to groups without IBD. They also explored the association of CD and UC with the risk of COPD and asthma.

Incidents of COPD reached 11,196 while asthma cases totalled 9,831 over a median follow-up of 11.9 years. Individuals with IBD had a higher risk of developing COPD (HR, 1.54, 95 percent confidence interval [CI], 1.33‒1.79) and asthma (HR, 1.52, 95 percent CI, 1.29‒1.79) than those without IBD. [Am J Med 2025;138:42-50.E5]

Participants with CD and UC also showed an increased risk of COPD (CD: HR, 1.71, 95 percent CI, 1.36‒2.15; UC: HR, 1.45, 95 percent CI, 1.20‒1.75) and asthma (CD: HR, 1.73, 95 percent CI, 1.33‒2.25; UC: HR, 1.41, 95 percent CI, 1.15‒1.73) relative to those without IBD.

Previous findings

“Reduced lung function in patients with IBD has been observed in epidemiological studies over many years,” the investigators said.

A cross-sectional study in France showed half of IBD patients (50.8 percent) reporting respiratory symptoms. Another study also found an association between lung transfer factors for carbon monoxide abnormalities and the severity of IBD activity. [Inflamm Bowel Dis 2023;29:207-216; Respir Med 1998;92:516-522]

In a meta-analysis of four retrospective studies, the pooled risk ratio of IBD in COPD patients was 2.02 (95 percent CI, 1.56‒2.63). This finding was consistent with that of three population-based studies and one case-control study, which revealed a potential link between IBD and COPD. [BMC Pulm Med 2019;19:186; World J Gastroenterol 2019;25:6354-6364; Eur Respir J 2015;45:962-968]

Asthma cases

Only two studies examined the relationship between IBD and the risk of asthma previously: one performed among children in Italy and another in Taiwan. [Allergy Asthma Proc 2015;36:e92-e98; Int J Environ Res Public Health 2020;17:4255]

“The latter study in an adult cohort retrospectively reported a significant 50-percent increased risk of asthma in the IBD population compared with the non-IBD population,” the investigators said. [Int J Environ Res Public Health 2020;17:4255]

“In sum, results in our study were consistent with the previous findings, with prospective design further addressing the chronology of the onset of IBD and the development of respiratory diseases,” they added.