Increased risk of pneumonia among patients with inflammatory bowel disease: A comparison between patients treated with biologic therapies and with conventional drugs

Romano, Claudia; Sinagra, Emanuele; Criscuoli, Valeria; Orlando, Ambrogio; Maisano, S.; Cottone, Mario

doi:10.1016/j.crohns.2013.04.015

Cited by 5 publications

(5 citation statements)

References 3 publications

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“…There have been very few studies in the past that have analysed the incidence of pneumonia and the risk factors associated with pneumonia in the IBD population, specifically the impact of immunosuppressive medication use 7‐9 . Two retrospective studies that evaluated this subject relied solely on the ICD‐9 codes for the diagnosis of pneumonia 7,8 .…”

Section: Discussionmentioning

confidence: 99%

“…Amongst all infections, pneumonia was found to be the most common infection in both younger and older IBD patients 4 . However, there is a paucity of data on pneumonia among the IBD population, including the incidence, hospitalisation, mortality rate and risk factors influencing these outcomes, especially the role of immunosuppressive medications 7‐9 . More importantly, as per Infectious Diseases Society of America (IDSA) guideline, the diagnosis of pneumonia requires various clinical findings, including the presence of an infiltrate on chest X‐ray (CXR) 10 .…”

Section: Introductionmentioning

confidence: 99%

“…They relied solely on the ICD‐9 and 10 coding which could be inaccurate 7,8 . Furthermore, there is limited data regarding the consequences of pneumonia, that is hospitalisation rate and mortality 7‐9 . With the advent of SARS‐CoV‐2, it has become critically important to get an accurate determination of the incidence and risk factors associated with the development of pneumonia in the IBD population.…”

Section: Introductionmentioning

confidence: 99%

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The impact of IBD medications on risk of pneumonia and pneumonia‐related hospitalisation: a nationwide cohort study of 56 410 IBD patients

Khan

Patel

Trivedi

et al. 2021

Aliment Pharmacol Ther

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Summary Background There are limited data on the incidence of pneumonia and pneumonia‐related hospitalisation in the IBD population, and on any association of IBD medications with such outcomes. Aims To evaluate the impact of IBD medications on the risk of pneumonia, pneumonia‐related hospitalisations and death. Methods We conducted a retrospective cohort study of IBD patients from the nationwide Veteran Affairs (VA) dataset. The exposure of interest was different IBD medication groups. We estimated the incidence rate of pneumonia, pneumonia‐related hospitalisation and mortality based on IBD medication subgroups. We used a multivariable Cox regression to estimate the adjusted hazard ratios (AHR) and 95% confidence intervals (CIs) for these outcomes. Results Out of 56 410 patients with IBD, 3759 developed pneumonia, 1489 were hospitalised, and 248 died within 30 days of their pneumonia diagnosis. The crude incidence rates of pneumonia, pneumonia‐related hospitalisation and pneumonia‐related mortality were 6.47, 2.52 and 0.43, respectively, per 1000 person‐years. In multivariable Cox regression analysis, compared to 5‐ASA alone, anti‐TNF medication was associated with an increased risk of pneumonia (AHR 1.39; 95% CI 1.22‐1.59) and hospitalisation (AHR 1.61; 95% CI 1.31‐1.98). Use of prednisone in the prior 30 days was associated with increased risk of pneumonia (AHR 2.14; 95% CI 1.92‐2.38) and hospitalisation (AHR 2.44; 95% CI 2.08‐2.88). Conclusion Anti‐TNF medications and prednisone use may be associated with increased risk of developing pneumonia and pneumonia‐related hospitalisation. Physicians should evaluate the risk–benefit ratio of IBD medications, especially in the elderly population.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The impact of IBD medications on risk of pneumonia and pneumonia‐related hospitalisation: a nationwide cohort study of 56 410 IBD patients

Khan

Patel

Trivedi

et al. 2021

Aliment Pharmacol Ther

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“…The seven kernel targets belong to inflammatory and immune-re- showed that the patients were at increased risk for the occurrence of pneumonia with inflammatory bowel diseases (Romano et al, 2013). The COVID-19 receptor ACE2 is particularly highly expressed in intestinal, and the possibility that patients with IBD might be susceptible to COVID-19 (Neurath, 2020).…”

Section: F I G U R Ementioning

confidence: 99%

Integrated network pharmacology and molecular docking strategy to explore the mechanism of medicinal and edible Astragali Radix‐Atractylodis Macrocephalae Rhizoma acting on pneumonia via immunomodulation

2020

J. Food Biochem.

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Pneumonia refers to a death-causing infection. Astragali Radix (AR) and Atractylodis Macrocephalae Rhizoma (AMR) are widely used as traditional tonic and promising edible immunomodulatory herbal medicine, but the systemic mechanism is not well understood. Therefore, a strategy based on network pharmacology and molecular docking was designed to explore the systemic mechanism of AR-AMR acting on pneumonia. After a series of bioinformatics assays, seven kernel targets were obtained, including TNF, IL6, IFNG, IL1B, IL10, IL4, and TLR9. And seven key compounds were identified as the synergy components of AR-AMR acting on pneumonia, the four key compounds belonging to AR were (3R)-3-(2-hydroxy-3,4-dimethoxyphenyl)-7chromanol, formononetin, quercetin, and kaempferol, the three key compounds belonging to AMR were atractylone, 14-acetyl-12-senecioyl-2E, 8E, 10E-atractylentriol, and α-Amyrin. The crucial pathways were mainly related to three modules, including immune diseases, infectious disease, and organismal systems. Collectively, these observations strongly suggest that the molecular mechanisms of AR-AMR regulating pneumonia were closely related to the correlation between inflammation and immune response. Practical applications Astragali radix and Atractylodis macrocephalae rhizoma can be used as "medicinefood homology" for dietary supplement. AR and AMR are widely used as a traditional tonic and promising edible immunomodulatory herbal medicine. The AR-AMR herb pairs are used for compatibility many times in the recommended prescriptions in COVID-19 develop pneumonia in China. However, the ingredients and mechanisms of AR-AMR acting on Pneumonia via immunomodulation are unclear. In this paper, bioinformatics and network biology were used to systematically explore the mechanisms of the AR-AMR herb pairs in treatment of pneumonia, and further analyze the correlation mechanism between it and COVID-19 develop pneumonia. To sum up, our study reveals the interrelationships between components, targets, and corresponding biological processes of AR-AMR acting on pneumonia. Understanding

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“…Patients with IBD who were infected with influenza were found to have higher rates of pneumonia and hospitalization compared with a non-IBD control group (9). Furthermore, patients with IBD who contract pneumococcal pneumonia are at increased risk of pneumonia-related hospitalizations associated with corticosteroids and tumor necrosis factor alpha inhibitors (TNFi) (7,11–13). To decrease the risks of VPD, preventative care guidelines emphasize the importance of obtaining a vaccine history and immunizing patients with IBD (14).…”

Section: Introductionmentioning

confidence: 99%

Patients With Inflammatory Bowel Disease Are at Increased Risk of Hospitalization Due to Respiratory Syncytial Virus

Smith,

Desai,

Barnes

et al. 2024

Am J Gastroenterol

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Background and Aims: Patients with inflammatory bowel disease (IBD) are at increased risk of developing respiratory infections. Respiratory syncytial virus (RSV) is a common respiratory virus with adverse outcomes in older adults. This study aimed to determine whether patients with IBD are at increased risk for a serious infection due to RSV. Methods: We conducted a retrospective study using the multi-institutional research network TriNetX to assess the risk of hospitalization in a cohort of patients with IBD compared to a non-IBD control cohort with RSV infection from January 1, 2007, to February 27, 2023. One-to-one (1:1) propensity score matching (PSM) was performed for demographic variables and RSV risk factors between the two cohorts. Risk was expressed as adjusted odds ratio (aOR) with 95% confidence interval (CI). Results: There were 794 patients in the IBD-RSV cohort and 93074 patients in the non-IBD RSV cohort. Mean age of the IBD-RSV cohort was 55.6 + 20 years old, 59% were female sex, 80% were White race and 56.9% had Crohn’s disease. The IBD-RSV cohort was at an increased risk for hospitalization (aOR 1.30, 95% CI 1.06-1.59). There was no difference in the risk (aOR 0.83, 95% CI 0.58-1.19) of a composite outcome of hospitalization-related complications between the two cohorts. Recent systemic corticosteroid use (<3 months) was associated with an increased risk of hospitalization (aOR 1.86, 95% CI 1.30-2.59) in the IBD-RSV cohort. Conclusions: We found that adult patients with IBD and RSV infection are at an increased risk for hospitalization and may benefit from the new RSV vaccine recommended for adults aged 60 years and older.

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Increased risk of pneumonia among patients with inflammatory bowel disease: A comparison between patients treated with biologic therapies and with conventional drugs

Cited by 5 publications

References 3 publications

The impact of IBD medications on risk of pneumonia and pneumonia‐related hospitalisation: a nationwide cohort study of 56 410 IBD patients

The impact of IBD medications on risk of pneumonia and pneumonia‐related hospitalisation: a nationwide cohort study of 56 410 IBD patients

Integrated network pharmacology and molecular docking strategy to explore the mechanism of medicinal and edible Astragali Radix‐Atractylodis Macrocephalae Rhizoma acting on pneumonia via immunomodulation

Patients With Inflammatory Bowel Disease Are at Increased Risk of Hospitalization Due to Respiratory Syncytial Virus

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