S442 Utilization of Diagnostic Testing and Indications for Long-Term Twice-Daily Proton Pump Inhibitor (PPI) Therapy for Gastroesophageal Reflux Disease (GERD) in a Large Healthcare System
Abstract
Introduction: Systemic lupus erythematosus (SLE), Rheumatoid arthritis (RA) and Sj¨ogren ’ s syndrome (SS) are multi-system rheumatologic diseases with known esophageal manifestations such as gastroesophageal re fl ux disease (GERD) from impaired peristalsis, decreased lower esophageal sphincter tone, and increased visceral hypersensitivity. However, there are no data on the prevalence of Barrett ’ s esophagus (BE). Methods: The aim of this study was to investigate the prevalence of Barrett ’ s esophagus in patients with SLE, RA and SS. Data were collected from a commercial database (Explorys Inc, Cleveland, OH), an aggregate of electronic health records data from 27 integrated healthcare systems in the US between 4/2017-4/2022. We identi fi ed patients with SLE based on Systematized Nomenclature of Medicine – Clinical Terms (SNOMED-CT). We compared the prevalence of BE at least 30 days after a diagnosis of each autoimmune condition to a control cohort without the autoimmune disease. We sub-categorized using demographics including gender, race, age, and BMI. We also included data on tobacco use, alcohol use, and proton pump inhibitor (PPI) therapy. Results: Of the 31,502,430 patients in the database, we identi fi ed 120,040 cases of SLE, 371,640 cases of RA, and 77,010 cases of SS. There was a greater female to male ratio for all three autoimmune diseases (Table). Prevalence of BE in SLE was 1.3% (OR 2.33, CI 2.21-2.45),
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Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence.
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