Supplemental Figure 1. Evaluation of concurrent hsCRP elevation in patients with and without peripheral blood eosinophilia by IBD type.
Supplemental Figure 2. Time to event analysis by presence of peripheral blood
eosinophilia and concurrent elevated high sensitivity C-reactive protein (hsCRP) (n= 98) compared to patients with only hsCRP elevation (n=303). A) Hospitalization in CD. B) Hospitalization in UC. C) Surgical resection in CD. D) Colectomy in UC.
Supplemental Table 1. Peripheral blood eosinophilia patterns by IBD type. a
CD (n=171)
UC (n=182) Degree of Eosinophilia
Mild Moderate Severe Unknown
166 (97.1) 5 (2.9)
0 0
171 (94.0) 6 (3.3)
0 5 (2.7)
0.25
Recurrent Eosinophilia 82 (48.0) 94 (51.6) 0.41
a Disease type missing on 106 patients
Supplemental Table 2. Six-year patterns of healthcare utilization, disease activity, and IBD medication use by presence of peripheral blood eosinophilia without comorbid PSC patients
PBE (n=376)
No PBE (n=1698) CD
(n=162)
UC (n=160)
CD (n=949)
UC (n=517)
p-value
Healthcare Utilization
ED, % 100
(61.7)
96 (60.0) 441 (46.5)# 222 (42.9)#
<0.0001
Hospitalization, % 114 (70.4)
93 (58.1) 442 (46.6)# 177 (34.2)#
<0.0001
IBD-Surgery, % 85 (52.5) 39 (24.4) 298 (31.4)# 62 (12.0)# <0.0001 Disease Activity and Quality of Life
HB-CD, median (IQR)
UCAI, median (IQR)
4.6 (5.6) --
-- 3.7 (4.6)
3 (4.7)#
--
-- 2.0 (4.5)#
<0.0001
<0.0001
hsCRP, % 108
(66.7)
102 (63.8)
415 (43.7)# 185 (35.8)#
<0.0001
ESR, % 84 (51.9) 82 (51.3) 300 (31.6)# 148
(28.6)#
<0.0001
SIBDQ, median (IQR)
49.5 (18) 50.9 (14.8)
52.9 (16.9)#
56.8 (13.6)#
<0.0001
IBD Medications
Prednisone, % 104
(64.2)
121 (75.6)
434 (45.7)# 261 (50.5)#
<0.0001
Biologic, % aTNF Othera
109 (67.3) 4 (2.5)
60 (37.5) 1 (0.6)
453 (47.7)#
5 (0.5)#
107 (20.7)#
2 (0.4)^
<0.0001 0.21
IM, % 94 (58.0) 84 (52.5) 573 (60.4)^ 193
(37.3)#
0.21
5-ASA, % 53 (32.7) 109 297 (31.3)^ 312 (60.3)^ 0.004
(68.1) Enteric Steroidsb,
%
41 (25.3) 11 (6.9) 175 (18.4)^ 37 (7.2)^ 0.58
Financial Charges Total Charges (USD), median (IQR)
$118,171 (307,115)
$66,576 (14,531)
$29,673 (131,694)#
$52,032 (192,226)#
<0.0001
a Natalizumab, vedolizumab, golimumab, rituximab
Statistical comparisons reported between PBE and No PBE groups. Disease specific statistical comparisons denoted by superscript symbols in No PBE columns.
b Oral budesonide, per rectum corticosteroid preparations
# p<0.05
^ p=NS
Supplementary Table 3. Univariate logistic regression modeling in both CD and UC for outcomes of hospitalization and IBD-related surgery.
Crohn’s Disease Ulcerative Colitis Hospitalizatio
n
p-value
Surgery
p-value
Hospitalizatio n
p-value
Surgery
p-value
PBE <0.0001 0.74 <0.0001 <0.0001
CRP <0.0001 <0.001 <0.0001 0.001
Age 0.171 0.29 0.019 0.776
Sex 0.128 0.70 0.922 0.383
BMI 0.997 <0.001 0.332 0.291
Psych 0.017 0.51 0.025 0.185
Asthma 0.548 0.45 0.089 0.431
Allergies 0.01 0.51 0.068 0.102
Med Allergies 0.002 0.47 0.035 0.018
Prior Surgery 0.002 0.45 0.001 <0.0001
Location 0.867 0.003 -- --
Behavior 0.074 <0.001 -- --
Perianal 0.508 0.89 -- --
Extent -- -- 0.017 0.015
Disease Duration 0.148 0.02 0.105 0.577
aTNF 0.001 <0.001 0.013 0.035
Steroids <0.0001 <0.001 <0.0001 0.045
IMs 0.004 <0.001 0.995 0.841
Smoking 0.01 0.90 0.05 .10
Narcotics <0.0001 <0.0001 <0.0001 <0.0001 Adrenal
Insufficiency
-- * 0.04 -- * -- *
Sjogren’s 0.55 0.52 0.467 -- *
Lupus 0.77 0.65 -- ** -- **
Systemic Sclerosis -- ** -- ** -- ** -- **
Rheumatoid Arthritis
0.37 0.80 0.75 0.08
PBE: peripheral blood eosinophilia; CRP: C-reactive protein; BMI: body mass index;
aTNF: anti-tumor necrosis factor; IM: immunomodulator
* Covariate excluded from model due to perfect outcome prediction
** Covariate excluded from model due to collinearity
Supplementary Table 4. Spearman rank-order correlation of number of years with
peripheral blood eosinophilia (range 0-6) and rates of healthcare utilization, disease activity scores, elevated inflammatory biomarker rates, quality of life metrics, and total financial charges.
CD
(n=1,148)
UC
(n=725)
Spearman’s rho p-value Spearman’s rho p-value No.
Hospitalization s
0.82 <0.00001 0.72 <0.00001
No. ED Visits 0.21 <0.00001 0.21 0.0001
No. IBD- Surgeries
0.17 <0.00001 0.13 0.0004
HBI 0.12 0.0001 -- --
UCAI -- -- 0.19 <0.00001
Years with hsCRP Elevation
0.19 <0.00001 0.30 <0.00001
Years with ESR
Elevation 0.19 <0.00001 0.21 <0.00001
SIBDQ -0.09 0.005 -0.16 0.0001
Total Charges
(USD) 0.21 <0.00001 0.27 <0.00001
CD: Crohn’s disease; UC: ulcerative colitis; ED: emergency department; IBD:
inflammatory bowel disease; HBI: Harvey-Bradshaw Index; UCAI: ulcerative colitis activity index; SIBDQ: short inflammatory bowel disease questionnaire; hsCRP: high- sensitivity C-reactive protein; ESR: erythrocyte sedimentation rate; USD: United States dollar
