Abstract Background The purpose of this study was to record and compare epidemiological and clinical characteristics of Crohn’s disease in patients with and without extraintestinal manifestations (EIMs). Methods We included patients managed at the Gastroenterology Clinic of GNA “G. Gennimatas”. The recorded epidemiological variables were sex, smoking status, disease duration, and disease location. Clinical course parameters included the number of biological therapies received, treatment intensifications, and CD-related surgeries. According to current ECCO guidelines, the EIMs that were recorded included uveitis, scleritis, episcleritis, oral manifestations, PSC, AIH, spondyloarthropathy, pyoderma gangrenosum, erythema nodosum, and Sweet’s syndrome. Statistical analyses were performed using SPSS v.23. Results Multivariate logistic regression was performed to assess the association of epidemiological and clinical characteristics with the presence of EIMs. A total of 435 patients were included (231 males, 53.1%), with a mean follow-up of 15.2 ± 9.3 years. Among them EIMs occurred in 108 patients (24.8%). Female sex (p = 0.030; OR = 1.66; 95% CI: 1.05–2.60) and smoking exposure (p = 0.032; OR = 1.79; 95% CI: 1.05–3.05) were both positively associated with the presence EIMs, while colonic disease location was not (p = 0.438). Statistically significant associations were identified for use of biologics (p = 0.049; OR = 1.31; 95% CI: 1.01–1.71) and treatment intensifications (p = 0.042; OR = 1.72; 95% CI: 1.02–2.90). In contrast, EIMs were less common noticed in patients with a history of major Crohn’s-related surgery (p = 0.07; OR = 0.41; 95% CI: 0.22–0.79). Conclusion In this single-center cohort, clinically meaningful differences were observed between patients with and without EIMs. Female sex and smoking independently increased the likelihood of EIMs, whereas prior major Crohn’s-related surgery was associated with a significantly lower risk, suggesting potential differences in disease behavior following surgical intervention. Additionally, patients with EIMs required more biological therapies and more frequent treatment intensifications. These findings emphasize the need for early identification of patients at risk for EIMs, as well as the need for individualized monitoring and treatment approaches to reduce complications and improve long-term outcomes. Conflict of interest: Tsitsigiannis, Konstantinos: No conflict of interest Kalakos, Nikolaos: I have no conflicts of interest to declare Thanos, Charalampos: No conflict of interest Georgakopoulou, Nikolia: No conflict of interest Dailianas, Dimitrios: No conflict of interest Piskopou, Dionysia: No conflict of interest Georgiou, Evgenia: No conflict of interest Triantafyllou, Margarita: No conflict of interest Striki, Athanasia: No conflict of interest Michalopoulos, George: speaker fees TAKEDA, ABBVIE, MSD, GALENICA, ENORASIS, AMGEM PFEIZER Karoumpalis, Ioannis: No conflict of interest
Tsitsigiannis et al. (2026) studied this question.