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Chronic Salmonella Infection Induced Intestinal Fibrosis
Published on: September 22, 2019
Increased risk of herpes zoster among 108 604 patients with inflammatory bowel disease
M D Long1, C Martin, R S Sandler
1Division of Gastroenterology and Hepatology, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7080, USA. millie_long@med.unc.edu
Background:
Patients with inflammatory bowel disease (IBD) on certain immunosuppressants have increased herpes zoster (HZ) risk.
Aim:
To determine the risk of HZ in IBD and how antitumour necrosis factor-alpha (anti-TNF) agents affect this risk.
Methods:
We performed a retrospective cohort and nested case-control study using administrative data from IMS LifeLink(®) Information Assets-Health Plan Claims Database. In the cohort, we identified IBD patients
Results:
The cohort included 50 932 patients with Crohn's disease (CD), 56 403 patients with ulcerative colitis (UC) and 1269 with unspecified IBD, matched to 434 416 individuals without IBD. The IBD cohort had increased HZ risk compared with non-IBD (IRR: 1.68, 95% CI: 1.60-1.76). After adjustment, IBD patients had a higher risk of HZ than non-IBD (HR: 1.49, 95% CI: 1.42-1.57). In the nested case-control multivariate-adjusted analyses, anti-TNF medications (OR: 1.81, 95% CI: 1.48-2.21), corticosteroids (OR: 1.73, 95% CI: 1.51-1.99) and thiopurines (OR: 1.85, 95% CI: 1.61-2.13) were independently associated with HZ. Risk of HZ was highest with combination anti-TNF and thiopurine therapy (OR: 3.29, 95% CI: 2.33-4.65).
Conclusions:
Patients with inflammatory bowel disease are at increased risk for herpes zoster. Use of thiopurines, anti-TNF agents, combination therapy and corticosteroids increases herpes zoster risk.
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