IBD Linked to Higher Risk of Interstitial Lung Disease in Long-Term Swedish Cohort Study

A large-scale, population-based study conducted in Sweden and published in The American Journal of Gastroenterology has shown that individuals with inflammatory bowel disease (IBD) face a significantly higher risk of developing interstitial lung diseases (ILD), reinforcing previously postulated but underexplored connections between pulmonary complications and IBD.

“Pulmonary manifestations have been postulated in inflammatory bowel disease (IBD), but supporting data are scarce,” the authors noted in the abstract. “We examined the risk of interstitial lung diseases (ILD) in IBD and its subtypes (ulcerative colitis, Crohn’s disease, and IBD-unclassified).”

The nationwide cohort study tracked 85,705 individuals diagnosed with IBD between 1969 and 2019, following them through 2021. For comparison, researchers identified 412,677 general-population controls matched by demographic characteristics. Diagnostic data for ILD were extracted from the Swedish National Patient Register, and hazard ratios were calculated using Cox regression analysis. A secondary analysis compared IBD patients with their IBD-free siblings.

After a median follow-up of 14 years, 438 IBD patients (0.51%) were diagnosed with ILD, compared to 1,253 individuals (0.30%) in the control group. This translated to incidence rates of 34 and 20 per 100,000 person-years, respectively. Overall, IBD patients had a 48% higher relative risk of ILD (adjusted hazard ratio [aHR]: 1.48; 95% CI: 1.30–1.69). Stratified analyses showed elevated risks in both ulcerative colitis and Crohn’s disease. Notably, when compared to their siblings, IBD patients demonstrated an even greater risk (aHR: 1.81; 95% CI: 1.43–2.27).

“In this nationwide cohort study of >85,000 patients with incident IBD, we found an increased risk of ILD,” the authors concluded.

Reference
Kochar B, Sun J, Olén O, Halfvarson J, Thuresson M, Hallowell R, Ludvigsson JF. Inflammatory bowel disease patients are at increased risk for interstitial lung diseases. Am J Gastroenterol. 2025 Aug 4. doi: 10.14309/ajg.0000000000003699. Epub ahead of print. PMID: 40758133.