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The Risk of Serious Infections Before and After Anti-TNF Therapy in Inflammatory Bowel Disease : A Retrospective Cohort Study

Holmgren, Johanna LU ; Fröborg, Anna ; Visuri, Isabella ; Halfvarson, Jonas ; Hjortswang, Henrik ; Karling, Pontus ; Myrelid, Pär ; Olén, Ola ; Ludvigsson, Jonas F and Grip, Olof LU (2022) In Inflammatory Bowel Diseases
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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publication status
epub
subject
in
Inflammatory Bowel Diseases
publisher
Oxford University Press
external identifiers
  • 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
2022-07-18 09:47:26
@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}},
  month        = {{07}},
  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}},
  year         = {{2022}},
}