Isabel A. Hujoel, MD1, Margaux LA. Hujoel, PhD2 1University of Washington, Seattle, WA; 2Brigham and Women's Hospital, Harvard Medical School, Seattle, WA
Introduction: Angiotensin receptor blockers are associated with the development of an enteropathy that closely resembles celiac disease. Angiotensin receptor blocker associated enteropathy and celiac disease share similar pathophysiologic mechanisms. Despite these similarities, the safety of these medications in those with celiac disease is unclear. We aimed to investigate outcomes of those with celiac disease on an angiotensin receptor blocker.
Methods: We used data from All of Us, a large publicly available longitudinal dataset involving individuals from the United States. We used survival analysis of time to first event after celiac disease diagnosis, allowing individuals to have a time-dependent covariate of angiotensin receptor blocker usage.
Results: There were 1,852 individuals with celiac disease (1,463 females, 389 males), with a median age at diagnosis of 49.8 years (range of 6-90.9 years). 1,590 individuals with celiac disease were not on angiotensin receptor blockers, while 137 were started on these medications after celiac disease diagnosis and 125 were started on these medications before diagnosis. Being on an angiotensin receptor blocker was associated with an increased hazard of iron deficiency (p=0.00016), diarrhea (p=0.00227), and abdominal pain (p=0.00294). There was no increased hazard for weight loss or vitamin deficiency.
Discussion: The prescription of angiotensin receptor blockers in those with celiac disease is associated with worse outcomes, specifically increased risk of iron deficiency, diarrhea, and abdominal pain. Although not investigated in this work, this association may be related to the similar pathophysiology between angiotensin receptor blocker associated enteropathy and celiac disease. These findings should prompt caution when prescribing angiotensin receptor blockers to those with celiac disease.
Disclosures:
Isabel Hujoel indicated no relevant financial relationships.
Margaux Hujoel indicated no relevant financial relationships.
Isabel A. Hujoel, MD1, Margaux LA. Hujoel, PhD2, 20, The Safety of Angiotensin Receptor Blockers in Celiac Disease, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.
