Increased risk of herpes zoster infection in patients with inflammatory bowel disease: a meta-analysis of cohort studies

Ning, Longui; Liu, Rongqiang; Li, Sha; Guo, Siyu; Du, Haojie; Zhang, Jie; Chen, Wenguo; Zhang, Fenming; Yu, Jinghua; Xu, Guofan

doi:10.1007/s10096-019-03706-9

Cited by 19 publications

(17 citation statements)

References 34 publications

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“…Ning et al demonstrated similar associations in their meta-analysis. 39 In this study, we describe an increase in GI infections in both UC and CD, with the majority being clinically diagnosed. However, a subanalysis of stool culture-confirmed diagnoses of infection with Salmonella, Shigella, Campylobacter or Clostridium difficile confirmed that this finding was not confounded by the fact that active IBD could be mistaken for GI infection.…”

Section: Discussionmentioning

confidence: 78%

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

Irving

Lusignan

Tang

et al. 2021

BMJ Open Gastroenterol

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ObjectiveTo 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.DesignMatched 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.Results18 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.ConclusionPeople 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 numberClinicaltrials.gov (NCT03835780).

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Section: Discussionmentioning

confidence: 78%

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

Irving

Lusignan

Tang

et al. 2021

BMJ Open Gastroenterol

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“…The included meta-analyses were published in English between 2014 and 2019. Various disease outcomes included cancers (n=7) [26][27][28][29][30][31], cardiovascular and cerebrovascular diseases (n=8) [32][33][34][35], obstetrical diseases (n=4) [36], neuropsychiatric disease (n=1) [38], otolaryngology and stomatology diseases (n=2) [41,43] and others (n=6) [37,[39][40]42,44] (Table 1). A total of 249 individual study estimates were included among the 19 articles.…”

Section: Resultsmentioning

confidence: 99%

“…The number of primary studies that pooled in 60.71% of meta-analyses was less than 10. Five meta-analyses did not provide the total number of participants [34,44], while 13 metaanalyses did not provide the total number of cases [26, 33-36, 41, 43, 44]. Among the meta-analyses that indicated the number of cases or participants, the median number of participants was 352,977 (811-940,572,339), and the median number of cases was 4,984 (117-120,312).…”

Section: Resultsmentioning

confidence: 99%

“…By stratifying based on the type of IBD, both CD and UC increased the risk of herpes zoster infection and the prevalence of vitamin D de ciency [44]; CD was associated with an increased prevalence of gallstone disease, but UC was not [40]. By stratifying based on gender, IBD was increased risk of sexual dysfunction both in male and ffemale [37] (Fig.…”

Section: Association Between Ibd and Other Diseasesmentioning

confidence: 98%

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The Associations between Inflammatory Bowel Disease and a Range of Other Diseases：Umbrella Review of Systematic Reviews and Meta-analyses

Cen

Liu

et al. 2021

Preprint

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Background Multiple meta-analyses have reported inflammatory bowel diseases (IBD) are associated with an increased risk of diverse diseases, but the evidence quality remains unclear. Objectives We aimed to summarize and evaluate this existing evidence on the associations between IBD and a range of diseases a-crossed from meta-analyses. Methods PubMed, the Cochrane Library Database, Embase, Web of Science, CNKI Databases, Wanfang Databases and VIP Database were searched to obtain eligible literatures from inception to November 1, 2019. We appraised the methodological quality of the included meta-analyses using AMSTAR 2 tool, and evaluated the quality of evidence for each outcome using the GRADE approach. Results Nineteen articles covering associations between IBD and 28 types of health outcomes were included. The methodological quality of meta-analyses was rated moderate for 5.26%, low for 21.05%, and critically low for 73.68%. Overall, summary effect estimates were significant in 26 meta-analyses. The evidence quality was rated high for 3.57%, moderate for 21.43%, low for 28.57%, and very low for 46.43%. Evidence quality was high for association between IBD and an increased periodontitis risk (OR = 4.55; 95% CI, 3.00-6.19). Evidence quality was moderate for associations between IBD and an increased thyroid cancer risk (OR = 1.75; 95% CI, 1.48–2.07), myocardial infarction incidence (RR = 1.12; 95% CI, 1.05–1.21), preterm birth incidence (OR = 1.85; 95% CI, 1.67–2.05), stillbirth incidence (OR = 1.57; 95% CI, 1.03–2.38), gallstone disease prevalence (OR = 1.72; 95% CI, 1.40–2.12), and vitamin D deficiency prevalence (OR = 1.64; 95% CI, 1.30–2.08). Conclusions Though, associations between IBD and diverse diseases have been extensively studied, few of the reported associations have robust support. Further well-designed studies are essential to determine whether IBD increases the risk of other diseases.

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“…Patients with IBD worldwide and in India treated with immunosuppressive therapies are at increased risk of developing herpes zoster at an early age compared with the general population [63]. It is also associated with serious morbidity and mortality much more than any other vaccine-preventable disease [64][65][66][67].…”

Section: Herpes Zostermentioning

confidence: 99%

A comprehensive review of vaccination in patients with inflammatory bowel diseases: An Indian perspective

Shah

Goenka

2020

Indian J Gastroenterol

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The disease burden of inflammatory bowel diseases (IBD) in India is estimated to be one of the highest in the world in the near future. Patients with IBD, particularly those on immunosuppressive therapy, are at increased risk for developing vaccinepreventable illnesses. Adult vaccination policy and vaccination in patients with IBD are presently being at a very low level in India. This review discusses in detail the need for vaccination, levels of immunosuppression, a brief account of live and inactivated vaccines, available vaccines, and their utility in patients with IBD, with a special focus on recent recommendations.

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Increased risk of herpes zoster infection in patients with inflammatory bowel disease: a meta-analysis of cohort studies

Cited by 19 publications

References 34 publications

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

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

The Associations between Inflammatory Bowel Disease and a Range of Other Diseases：Umbrella Review of Systematic Reviews and Meta-analyses

A comprehensive review of vaccination in patients with inflammatory bowel diseases: An Indian perspective

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