The Risk of Serious Infections Before and After Anti-TNF Therapy in Inflammatory Bowel Disease: A Retrospective Cohort Study.
anti-TNF
biologics
infections
inflammatory bowel disease
real-world data
Journal
Inflammatory bowel diseases
ISSN: 1536-4844
Titre abrégé: Inflamm Bowel Dis
Pays: England
ID NLM: 9508162
Informations de publication
Date de publication:
01 03 2023
01 03 2023
Historique:
received:
29
12
2021
pubmed:
2
7
2022
medline:
4
3
2023
entrez:
1
7
2022
Statut:
ppublish
Résumé
Serious infections have been observed in patients with inflammatory bowel disease (IBD) on anti-TNF use-but to what extent these infections are due to anti-TNF or the disease activity per se is hard to disentangle. We aimed to describe how the rates of serious infections change over time both before and after starting anti-TNF in IBD. Inflammatory bowel disease patients naïve to anti-TNF treatment were identified at 5 centers participating in the Swedish IBD Quality Register, and their medical records examined in detail. Serious infections, defined as infections requiring in-patient care, the year before and after the start of anti-TNF treatment were evaluated. Among 980 patients who started their first anti-TNF therapy between 1999 and 2016, the incidence rate of serious infections was 2.19 (95% CI,1.43-3.36) per 100 person years the year before and 2.11 (95% CI, 1.33-3.34) per 100 person years 1 year after treatment start. This corresponded to an incidence rate ratio 1 year after anti-TNF treatment of 0.97 (95% CI, 0.51-1.84). Compared with before anti-TNF therapy, the incidence of serious infection was significantly decreased more than 1 year after treatment (incidence rate ratio 0.56; 95% CI, 0.33-0.95; P = .03). In routine clinical practice in Sweden, the incidence rate of serious infection among IBD patients did not increase with anti-TNF therapy. Instead, serious infections seemed to decrease more than 1 year after initiation of anti-TNF treatment. The incidence rate of serious infection among inflammatory bowel disease patients did not increase with anti-TNF therapy compared with 1 year before treatment start. A decrease in incidence rate could be seen more than 1 year after initiation of anti-TNF.
Sections du résumé
BACKGROUND
Serious infections have been observed in patients with inflammatory bowel disease (IBD) on anti-TNF use-but to what extent these infections are due to anti-TNF or the disease activity per se is hard to disentangle. We aimed to describe how the rates of serious infections change over time both before and after starting anti-TNF in IBD.
METHODS
Inflammatory bowel disease patients naïve to anti-TNF treatment were identified at 5 centers participating in the Swedish IBD Quality Register, and their medical records examined in detail. Serious infections, defined as infections requiring in-patient care, the year before and after the start of anti-TNF treatment were evaluated.
RESULTS
Among 980 patients who started their first anti-TNF therapy between 1999 and 2016, the incidence rate of serious infections was 2.19 (95% CI,1.43-3.36) per 100 person years the year before and 2.11 (95% CI, 1.33-3.34) per 100 person years 1 year after treatment start. This corresponded to an incidence rate ratio 1 year after anti-TNF treatment of 0.97 (95% CI, 0.51-1.84). Compared with before anti-TNF therapy, the incidence of serious infection was significantly decreased more than 1 year after treatment (incidence rate ratio 0.56; 95% CI, 0.33-0.95; P = .03).
CONCLUSIONS
In routine clinical practice in Sweden, the incidence rate of serious infection among IBD patients did not increase with anti-TNF therapy. Instead, serious infections seemed to decrease more than 1 year after initiation of anti-TNF treatment.
The incidence rate of serious infection among inflammatory bowel disease patients did not increase with anti-TNF therapy compared with 1 year before treatment start. A decrease in incidence rate could be seen more than 1 year after initiation of anti-TNF.
Autres résumés
Type: plain-language-summary
(eng)
The incidence rate of serious infection among inflammatory bowel disease patients did not increase with anti-TNF therapy compared with 1 year before treatment start. A decrease in incidence rate could be seen more than 1 year after initiation of anti-TNF.
Identifiants
pubmed: 35776552
pii: 6625867
doi: 10.1093/ibd/izac097
pmc: PMC9977242
doi:
Substances chimiques
Tumor Necrosis Factor Inhibitors
0
Tumor Necrosis Factor-alpha
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
339-348Investigateurs
Malin Olsson
(M)
Jonas Bengtsson
(J)
Hans Strid
(H)
Marie Andersson
(M)
Susanna Jäghult
(S)
Michael Eberhardson
(M)
Caroline Nordenvall
(C)
Jan Björk
(J)
Ulrika L Fagerberg
(UL)
Martin Rejler
(M)
Mattias Block
(M)
Eva Angenete
(E)
Per M Hellström
(PM)
Informations de copyright
© 2022 Crohn’s & Colitis Foundation. Published by Oxford University Press on behalf of Crohn’s & Colitis Foundation.
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