Risk of common infections in people with inflammatory bowel disease in primary care: a population-based cohort study

Objective To evaluate the risk of common infections in individuals with inflammatory bowel disease (IBD) [ulcerative colitis and Crohn’s disease] compared with matched controls in a contemporary UK primary care population.Design Matched cohort analysis (2014–2019) using the Royal College of General...

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Autores principales:	Peter M Irving, Kevin Barrett, Daniel Tang, Monica Nijher
Formato:	article
Lenguaje:	EN
Publicado:	BMJ Publishing Group 2021
Materias:	Diseases of the digestive system. Gastroenterology RC799-869
Acceso en línea:	https://doaj.org/article/ca1bf32f63774760a1aa776df45c2ac8
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spelling	oai:doaj.org-article:ca1bf32f63774760a1aa776df45c2ac82021-12-04T19:30:05ZRisk of common infections in people with inflammatory bowel disease in primary care: a population-based cohort study10.1136/bmjgast-2020-0005732054-4774https://doaj.org/article/ca1bf32f63774760a1aa776df45c2ac82021-11-01T00:00:00Zhttps://bmjopengastro.bmj.com/content/8/1/e000573.fullhttps://doaj.org/toc/2054-4774Objective To evaluate the risk of common infections in individuals with inflammatory bowel disease (IBD) [ulcerative colitis and Crohn’s disease] compared with matched controls in a contemporary UK primary care population.Design Matched cohort analysis (2014–2019) using the Royal College of General Practitioners Research and Surveillance Centre primary care database. Risk of common infections, viral infections and gastrointestinal infections (including a subset of culture-confirmed infections), and predictors of common infections, were evaluated using multivariable Cox proportional hazards models.Results 18 829 people with IBD were matched to 73 316 controls. People with IBD were more likely to present to primary care with a common infection over the study period (46% vs 37% of controls). Risks of common infections, viral infections and gastrointestinal infections (including stool culture-confirmed infections) were increased for people with ulcerative colitis and Crohn’s disease compared with matched controls (HR range 1.12–1.83, all p<0.001). Treatment with oral glucocorticoid therapy, immunotherapies and biologic therapy, but not with aminosalicylates, was associated with increased infection risk in people with IBD. Despite mild lymphopenia and neutropenia being more common in people with IBD (18.4% and 1.9%, respectively) than in controls (6.5% and 1.5%, respectively), these factors were not associated with significantly increased infection risk in people with IBD.Conclusion People with IBD are more likely to present with a wide range of common infections. Health professionals and people with IBD should remain vigilant for infections, particularly when using systemic corticosteroids, immunotherapies or biologic agents.Trial registration number Clinicaltrials.gov (NCT03835780).Peter M IrvingKevin BarrettDaniel TangMonica NijherBMJ Publishing GrouparticleDiseases of the digestive system. GastroenterologyRC799-869ENBMJ Open Gastroenterology, Vol 8, Iss 1 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Diseases of the digestive system. Gastroenterology RC799-869
spellingShingle	Diseases of the digestive system. Gastroenterology RC799-869 Peter M Irving Kevin Barrett Daniel Tang Monica Nijher Risk of common infections in people with inflammatory bowel disease in primary care: a population-based cohort study
description	Objective To evaluate the risk of common infections in individuals with inflammatory bowel disease (IBD) [ulcerative colitis and Crohn’s disease] compared with matched controls in a contemporary UK primary care population.Design Matched cohort analysis (2014–2019) using the Royal College of General Practitioners Research and Surveillance Centre primary care database. Risk of common infections, viral infections and gastrointestinal infections (including a subset of culture-confirmed infections), and predictors of common infections, were evaluated using multivariable Cox proportional hazards models.Results 18 829 people with IBD were matched to 73 316 controls. People with IBD were more likely to present to primary care with a common infection over the study period (46% vs 37% of controls). Risks of common infections, viral infections and gastrointestinal infections (including stool culture-confirmed infections) were increased for people with ulcerative colitis and Crohn’s disease compared with matched controls (HR range 1.12–1.83, all p<0.001). Treatment with oral glucocorticoid therapy, immunotherapies and biologic therapy, but not with aminosalicylates, was associated with increased infection risk in people with IBD. Despite mild lymphopenia and neutropenia being more common in people with IBD (18.4% and 1.9%, respectively) than in controls (6.5% and 1.5%, respectively), these factors were not associated with significantly increased infection risk in people with IBD.Conclusion People with IBD are more likely to present with a wide range of common infections. Health professionals and people with IBD should remain vigilant for infections, particularly when using systemic corticosteroids, immunotherapies or biologic agents.Trial registration number Clinicaltrials.gov (NCT03835780).
format	article
author	Peter M Irving Kevin Barrett Daniel Tang Monica Nijher
author_facet	Peter M Irving Kevin Barrett Daniel Tang Monica Nijher
author_sort	Peter M Irving
title	Risk of common infections in people with inflammatory bowel disease in primary care: a population-based cohort study
title_short	Risk of common infections in people with inflammatory bowel disease in primary care: a population-based cohort study
title_full	Risk of common infections in people with inflammatory bowel disease in primary care: a population-based cohort study
title_fullStr	Risk of common infections in people with inflammatory bowel disease in primary care: a population-based cohort study
title_full_unstemmed	Risk of common infections in people with inflammatory bowel disease in primary care: a population-based cohort study
title_sort	risk of common infections in people with inflammatory bowel disease in primary care: a population-based cohort study
publisher	BMJ Publishing Group
publishDate	2021
url	https://doaj.org/article/ca1bf32f63774760a1aa776df45c2ac8
work_keys_str_mv	AT petermirving riskofcommoninfectionsinpeoplewithinflammatoryboweldiseaseinprimarycareapopulationbasedcohortstudy AT kevinbarrett riskofcommoninfectionsinpeoplewithinflammatoryboweldiseaseinprimarycareapopulationbasedcohortstudy AT danieltang riskofcommoninfectionsinpeoplewithinflammatoryboweldiseaseinprimarycareapopulationbasedcohortstudy AT monicanijher riskofcommoninfectionsinpeoplewithinflammatoryboweldiseaseinprimarycareapopulationbasedcohortstudy
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Risk of common infections in people with inflammatory bowel disease in primary care: a population-based cohort study

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