P0742 - Prevalence and Risk of Migraine in Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis

Arankesh Mahadevan, MBBS¹, Yashwitha Sai Pulakurthi, MBBS², Rishabh Baskara Salian, MBBS³, Naga Vamsi Krishna Machineni, MBBS⁴, Sudhir Reddy. Pasham, MD⁵, Jayasree Ravilla, MD⁶, Prabhsimran Singh, MBBS⁷, Jahnavi Ethakota, MBBS⁸, Harshavardhan Polamarasetty, MBBS⁹, Rupak Desai, MBBS^10
1SRM Medical College Hospital and Research Centre, Chennai, Tamil Nadu, India; ²New York Medical College-Saint Michael's Medical Center, Newark, NJ; ³Kasturba Medical College, Mangalore, Karnataka, India; ⁴Siddhartha Medical College, Cincinnati, OH; ⁵Guthrie Robert Packer Hospital, Sayre, PA; ⁶Monmouth Medical Center/RWJBH, Long Branch, NJ; ⁷Government Medical College, Amritsar, Punjab, India; ⁸Henry Ford Allegiance Health, Jackson, MI; ⁹Maharajah's Institute of Medical Sciences, Newark, Andhra Pradesh, India; ¹⁰Outcomes Research, Atlanta, GA

Introduction: Inflammatory bowel disease (IBD) is a complex autoimmune condition characterized by diverse risk factors and pathophysiologies. There is a hypothesized linkage between neurological and gastrointestinal disorders, possibly through the alterations in the "gut-brain axis". Migraines, defined as episodic neuroinflammatory conditions, are believed to have a potential association with systemic inflammation. However, the existing literature lacks comprehensive exploration of IBD as a potential risk factor for migraines. Our aim is to analyze the association between migraines and IBD through a systematic review and meta-analysis.

Methods: We conducted an extensive search of PubMed, Scopus, and Google Scholar until May 2023, screening for studies that reported the prevalence of migraines in IBD patients using MeSH and TiAB terms. In addition, we performed a cross-citation search. Our literature search yielded 117 reports. After pre-screening exclusion, 66 reports were eligible for screening. Binary random-effects models were used to perform meta-analysis. The I2 statistics was used to assess heterogeneity, and sensitivity analysis was done using the leave-one-out method.

Results: Our meta-analysis analyzed six studies- three cross-sectional, two prospective, and one retrospective, originating from the USA (2), Brazil (1), Israel (1), Switzerland (1), and the UK (1). We evaluated 62,325 IBD patients (46.7% male) and 2,537,535 controls. The pooled prevalence of migraine was higher in IBD compared to controls (7.5% vs. 2.7%). However, our forest plot analysis showed a non-significant increase in migraine risk in IBD, both unadjusted (OR 1.30, 95% CI 0.81-2.07) and adjusted (OR 1.55, 95% CI 0.98-2.44). Heterogeneity was substantial with p< 0.01 for both unadjusted (I²=92.87%), and adjusted (I²=82.03%) analysis. Sensitivity analysis using the leave-one-out analysis confirmed this finding.



In the Crohn's disease subgroup, we observed a non-significant association with migraine risk, with heterogeneity (p< 0.01) remaining substantial (unadjusted OR 1.06, 95% CI 0.17-6.37, I²=92.57%, p=0.95; adjusted OR 0.70, 95% CI 0.26-1.86, I²=87.45%, p=0.48).

Discussion: No significant association between the risk of migraine and IBD was found in our study. The lack of association might be attributable to heterogeneous data sources and inadequate power for this analysis. Further prospective studies are warranted to investigate the risk of IBD in migraine.



Disclosures:


Arankesh Mahadevan, MBBS¹, Yashwitha Sai Pulakurthi, MBBS², Rishabh Baskara Salian, MBBS³, Naga Vamsi Krishna Machineni, MBBS⁴, Sudhir Reddy. Pasham, MD⁵, Jayasree Ravilla, MD⁶, Prabhsimran Singh, MBBS⁷, Jahnavi Ethakota, MBBS⁸, Harshavardhan Polamarasetty, MBBS⁹, Rupak Desai, MBBS¹⁰. P0742 - Prevalence and Risk of Migraine in Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.