Infective issues about anti‐tumor necrosis factor (TNF)‐α agents in inflammatory bowel disease (IBD) remain controversial, especially when compared with nonbiological treatments. This study aimed to evaluate the incidence and prevalence of severa...
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https://www.riss.kr/link?id=O106943053
2021년
eng
0815-9319
1440-1746
SCI;SCIE;SCOPUS
학술저널
Journal of gastroenterology and hepatology
1859-1868 [※수록면이 p5 이하이면, Review, Columns, Editor's Note, Abstract 등일 경우가 있습니다.]
0
상세조회0
다운로드다국어 초록 (Multilingual Abstract)
Infective issues about anti‐tumor necrosis factor (TNF)‐α agents in inflammatory bowel disease (IBD) remain controversial, especially when compared with nonbiological treatments. This study aimed to evaluate the incidence and prevalence of severa...
Infective issues about anti‐tumor necrosis factor (TNF)‐α agents in inflammatory bowel disease (IBD) remain controversial, especially when compared with nonbiological treatments. This study aimed to evaluate the incidence and prevalence of several infections in anti‐TNF‐α‐exposed patients compared with nonbiological treatments.
All naïve IBD subjects treated with anti‐TNF‐α and matched nonbiologic‐exposed patients were included.
Among 3453 patients in the database, 288 anti‐TNF‐α‐exposed subjects and 288 nonbiologic‐exposed IBD controls met inclusion criteria. Fifty‐eight infections (20.1%) occurred during anti‐TNF‐α treatment versus 23 (8%) in the matched group (odds ratio [OR] 2.9, P < 0.001) (incidence 5.72 vs 0.96/100 patient‐years, incidence ratio [IR] 6, P < 0.001). IR was higher for anti‐TNF‐α versus mesalamine/sulfasalazine (IR 40.8, P < 0.001), similar to azathioprine/6‐mercaptopurine/methotrexate (IR 0.78, P = 0.32) and lower than corticosteroids (IR 0.05, P < 0.001). The incidence rate of serious infections was 1.3 in the anti‐TNF‐α‐exposed versus 0.38/100 patient‐years in nonexposed subjects (IR 3.44, P = 0.002), without significant difference between anti‐TNF‐α and azathioprine/6‐mercaptopurine/methotrexate (1.3 vs 3.03/100 patient‐years, IR 0.43, P = 0.1). Predictors of infections in anti‐TNF‐α‐exposed patients were concomitant use of systemic steroids (OR 1.9, P = 0.02) or azathioprine (OR 2.6, P = 0.01) and a body mass index < 18.5 at time of infection (OR 2.2, P = 0.01).
The risk of developing infections during anti‐TNF‐α therapy remains high, although not dissimilar to that found for other immunosuppressants, while concomitant immunosuppression and malnutrition appear the most important causes of infection.
Gastrointestinal: Recurrent colic and the percutaneous endoscopic gastrojejunostomy