The Risk of Serious Infections Before and After Anti-TNF Therapy in Inflammatory Bowel Disease : A Retrospective Cohort Study
(2023) In Inflammatory Bowel Diseases 29(3). p.339-348- Abstract
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... (More)
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.
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- author
- Holmgren, Johanna LU ; Fröborg, Anna ; Visuri, Isabella ; Halfvarson, Jonas ; Hjortswang, Henrik ; Karling, Pontus ; Myrelid, Pär ; Olén, Ola ; Ludvigsson, Jonas F and Grip, Olof LU
- author collaboration
- organization
- publishing date
- 2023
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Inflammatory Bowel Diseases
- volume
- 29
- issue
- 3
- pages
- 339 - 348
- publisher
- Oxford University Press
- external identifiers
-
- scopus:85149186794
- pmid:35776552
- ISSN
- 1536-4844
- DOI
- 10.1093/ibd/izac097
- language
- English
- LU publication?
- yes
- additional info
- © 2022 Crohn’s & Colitis Foundation. Published by Oxford University Press on behalf of Crohn’s & Colitis Foundation.
- id
- 3fe8a9bc-7743-4a15-8ac2-2195d6d5db43
- date added to LUP
- 2022-07-17 15:38:12
- date last changed
- 2024-10-01 03:59:07
@article{3fe8a9bc-7743-4a15-8ac2-2195d6d5db43,
abstract = {{<p>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.</p><p>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.</p><p>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).</p><p>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.</p>}},
author = {{Holmgren, Johanna and Fröborg, Anna and Visuri, Isabella and Halfvarson, Jonas and Hjortswang, Henrik and Karling, Pontus and Myrelid, Pär and Olén, Ola and Ludvigsson, Jonas F and Grip, Olof}},
issn = {{1536-4844}},
language = {{eng}},
number = {{3}},
pages = {{339--348}},
publisher = {{Oxford University Press}},
series = {{Inflammatory Bowel Diseases}},
title = {{The Risk of Serious Infections Before and After Anti-TNF Therapy in Inflammatory Bowel Disease : A Retrospective Cohort Study}},
url = {{http://dx.doi.org/10.1093/ibd/izac097}},
doi = {{10.1093/ibd/izac097}},
volume = {{29}},
year = {{2023}},
}