Low Incidence of Varicella in Pediatric Patients With Inflammatory Bowel Disease
Freddy Caldera1, Mary S Hayney2, Francis A Farraye3
1Department of Medicine, Division of Gastroenterology and Hepatology, School of Medicine & Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA.
Insights
Pediatric patients with inflammatory bowel disease (IBD) treated with immune-modifying therapies have a low incidence of varicella (chickenpox). This study found no significant difference in varicella rates compared to children without IBD.
Area of Science:
- Pediatric Gastroenterology
- Immunology
- Infectious Disease Epidemiology
Background:
- Immune-modifying therapies are crucial for managing pediatric inflammatory bowel disease (IBD).
- These therapies can increase the risk of infections, including varicella (chickenpox).
Purpose of the Study:
- To evaluate the incidence of varicella in pediatric patients with IBD receiving immune-modifying therapy.
- To compare varicella rates in IBD patients versus a matched non-IBD cohort.
Main Methods:
- Retrospective analysis of a US commercial insurance claims database (Optum Clinformatics, 2007-2022).
- Inclusion of 5,368 patients aged 21 or younger diagnosed with IBD.
- Matching IBD patients to a non-IBD cohort to assess varicella incidence.
Main Results:
- Low incidence of varicella observed in both IBD (0.570 per 1,000 person-years) and non-IBD (0.297 per 1,000 person-years) cohorts.
- Cumulative varicella incidence at year 4 was 0.27% for IBD and 0.18% for non-IBD.
- No varicella-related hospitalizations or deaths were reported in either group.
Conclusions:
- Pediatric patients with IBD on immune-modifying therapy exhibit a low incidence of varicella.
- The risk of varicella does not appear significantly elevated in this population compared to controls.
Introduction:
Immune-modifying therapies in pediatric inflammatory bowel disease (IBD) increase infection risks, including varicella.
Methods:
Using Optum's deidentified Clinformatics Data Mart Database, a nationwide US commercial insurance claims database (2007-2022), we conducted a retrospective study of 5,368 patients with IBD aged 21 years or younger matched to a non-IBD cohort. The primary outcome was incidence of varicella.
Results:
Varicella incidence was low in both groups (IBD: 0.570 vs non-IBD: 0.297 per 1,000 person-years, P = 0.23). At year 4, cumulative varicella incidence was 0.27% for IBD and 0.18% for non-IBD ( P = 0.24). No hospitalizations or deaths occurred.
Discussion:
Despite immune-modifying therapy, pediatric patients with IBD demonstrate low varicella incidence.
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