Peer-Reviewed Journal Details
Mandatory Fields
Toruner, M,Loftus, EV,Harmsen, WS,Zinsmeister, AR,Orenstein, R,Sandborn, WJ,Colombel, JF,Egan, LJ
2008
April
Gastroenterology
Risk factors for opportunistic infections in patients with inflammatory bowel disease
Published
()
Optional Fields
POPULATION-BASED COHORT CROHNS-DISEASE ULCERATIVE-COLITIS MAINTENANCE THERAPY COPENHAGEN COUNTY FOLLOW-UP INFLIXIMAB LYMPHOMA AZATHIOPRINE TRIAL
134
929
936
Background & Aims: We sought to identify and quantify the clinical factors that were associated with opportunistic infections in inflammatory bowel disease patients. Methods: We identified 100 consecutive IBD patients with opportunistic infections. For each case, 2 matched IBD patients who did not have a history of opportunistic infection were selected as controls. Conditional logistic regression was used to assess associations between putative risk factors and opportunistic infections, presented as odds ratios (OR) and 95% confidence intervals (CIs). Results: In univariate analysis, use of corticosteroids (OR, 3.4; 95% CI, 1.8-6.2), azathioprine/6-mercaptopurine (OR, 3.1; 95% CI, 1.7-5.5), and infliximab (OR, 4.4; 95% Cl, 1.2-17.1) were associated individually with significantly increased odds for opportunistic infection. Multivariate analysis indicated that use of any one of these drugs yielded an OR of 2.9 (95% CI, 1.5-5.3), whereas use of 2 or 3 of these drugs yielded an OR of 14.5 (95% Cl, 4.9-43) for opportunistic infection. The relative risk of opportunistic infection was greatest in IBD patients seen at older than 50 years of age (OR, 3.0. 95% CI, 1.2-7.2, relative to those 24 years or younger). No patient died from opportunistic infection. Conclusions: Immunosuppressive medications, especially when used in combination, and older age are associated with increased risk of opportunistic infections. The absolute risk of opportunistic infection in IBD patients remains to be determined, as does any potential benefit of any preventive strategy.
DOI 10.1053/j.gastro.2008.01.012
Grant Details
Publication Themes