Smoking is Associated With Extra-intestinal Manifestations in Inflammatory Bowel Disease

Severs, Mirjam; Erp, S. J. H. van; Valk, Mirthe E. van der; Mangen, Marie-Josée J.; Fidder, Herma H.; Have, Mike van der; Bodegraven, Ad A. van; Jong, Dirk J. de; Woude, C. Janneke van der; Romberg‐Camps, Mariëlle; Clemens, Cees H.; Jansen, Jeroen M.; Meeberg, Paul C. van de; Mahmmod, Nofel; Ponsioen, Cyriel Y.; Bolwerk, Clemens; Vermeijden, J. Reinoud; Pierik, Marieke; Siersema, Peter D.; Leenders, Max; Jong, Andrea E. van der Meulen–de; Dijkstra, Gerard; Oldenburg, Bas

doi:10.1093/ecco-jcc/jjv238

Cited by 49 publications

(44 citation statements)

References 42 publications

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“…13 Smoking has also been associated with the presence or development of extraintestinal manifestations in IBD, with arthralgias being 1 of the most common. 14 In our cohort we observed active smokers to be at a 3-fold increased risk for infections with VDZ, and the only noninfectious adverse event reported in active smokers was arthralgia. Given respiratory tract infections and arthralgias were 2 of the most common adverse events observed, this highlights the importance of counseling active smokers on smoking cessation when starting VDZ to optimize the safety profile.…”

Section: Discussionmentioning

confidence: 49%

Retrospective Analysis of Safety of Vedolizumab in Patients With Inflammatory Bowel Diseases

Meserve

Aniwan

Koliani-Pace

et al. 2019

Clinical Gastroenterology and Hepatology

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BACKGROUND & AIMS: There are few real-world data on the safety of vedolizumab for treatment of Crohn's disease (CD) or ulcerative colitis (UC). We quantified rates and identified factors significantly associated with infectious and non-infectious adverse events in clinical practice. METHODS: We performed a retrospective review of data from a multicenter consortium database (from May 2014 through June 2017). Infectious and non-infectious adverse events were defined as those requiring antibiotics, hospitalization, vedolizumab discontinuation, or resulting in death. Rates were quantified as proportions and events per 100 patient years of exposure (PYE) or follow up (PYF). We performed multivariable logistic regression analyses to identify factors significantly associated with events and reported as odds ratios (OR) with 95% CIs. RESULTS: Our analysis comprised 1087 patients (650 with CD and 437 with UC; 55% female; median age, 37 years) with 861 PYE and 955 PYF. Infections were observed in 68 patients (6.3%; 7.9 per 100 PYE, 7.1 per 100 PYF); gastrointestinal infections (n [ 31, 2.4 per 100 PYE, 2.2 per 100 PYF) and respiratory infections (n [ 14, 1.6 per 100 PYE, 1.5 per 100 PYF) were the most common. Arthralgias were the most common non-infectious adverse events (n [ 31, 2.9%; 3.6 per 100 PYE). Two patients developed malignancies (squamous cell skin cancer and colorectal cancer; 0.23 per 100 PYE, 0.21 per 100 PYF). Active smoker status (OR, 3.39) and number of concomitant immunosuppressive agents (corticosteroids or immunomodulators; OR, 1.72 per agent) used were independently associated with infections. CONCLUSION: In a retrospective cohort study of patients with IBD, we found vedolizumab to be well tolerated with an overall favorable safety profile. Active smoking and concomitant use of immunosuppressive agents were independently associated with infections

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Section: Discussionmentioning

confidence: 49%

Retrospective Analysis of Safety of Vedolizumab in Patients With Inflammatory Bowel Diseases

Meserve

Aniwan

Koliani-Pace

et al. 2019

Clinical Gastroenterology and Hepatology

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“…Nonetheless, in a cross-sectional analysis of three IBD cohort studies, smoking has been identified as an independent risk factor for EIM in both CD and UC. 111 Of note, this association between smoking and EIM was dose-dependent. 111 Furthermore, smoking cessation was associated with a reduction of EIM prevalence.…”

Section: Environmental Factorsmentioning

confidence: 93%

“…111 Of note, this association between smoking and EIM was dose-dependent. 111 Furthermore, smoking cessation was associated with a reduction of EIM prevalence. 111 Both findings make the results more reliable.…”

Section: Environmental Factorsmentioning

confidence: 93%

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Extraintestinal manifestations in inflammatory bowel disease – epidemiology, genetics, and pathogenesis

Greuter

Vavricka

2019

Expert Review of Gastroenterology & Hepatology

136

111

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Inflammatory bowel disease (IBD) is a chronic inflammatory disorder, primarily of, but not restricted to the gut. Extraintestinal manifestations (EIMs) are frequently observed and involve the joints, eyes, hepatobiliary tract, and skin. Areas covered: In this review, we discuss classical EIM focusing on epidemiology, genetics, and pathogenesis, highlighting recent advances in the understanding of EIM. We further discuss treatment-induced immunological phenomena, which are increasingly recognized and might challenge IBD-treating physicians in the era of biological treatment. Expert opinion: EIM considerably contributes to morbidity and mortality. Genetic studies have revealed a common genetic background between EIM and IBD and among specific EIM. Identified protein interactions have been shown to cluster in shared biological pathways. However-despite these recent advances-pathogenesis of EIM is at best partially understood. Several pathogenic mechanisms have been proposed such as upregulation of tumor necrosis factor, aberrant lymphocyte homing, and cross-reactive antigen presentation. It still remains unclear whether EIM is a direct result of the inflammatory process in the gut or rather a consequence of a shared genetic background leading to dysfunctional immune responses to environmental stimuli. Exploration and understanding of EIM genetics and pathophysiology will pave the road for better and more efficacious treatment options in the future.

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“…Several studies didn't prove sex as risk factor [12,14]. Correlation between smoking and rheumatic manifestations of IBD had been discussed with contradictory results [15]. The impact of intestinal disease on risk for AS showed different conclusions.…”

Section: Authorsmentioning

confidence: 99%

Axial Spondyloarthritis in Inflammatory Bowel Diseases

Hana¹

2017

MJCCS

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Smoking is Associated With Extra-intestinal Manifestations in Inflammatory Bowel Disease

Abstract: There is a robust dose-dependent association between active smoking and EIMs in both CD and UC patients. Smoking cessation was found to result in a rapid reduction of EIM prevalence to levels encountered in never smokers.

Cited by 49 publications

References 42 publications

Retrospective Analysis of Safety of Vedolizumab in Patients With Inflammatory Bowel Diseases

Retrospective Analysis of Safety of Vedolizumab in Patients With Inflammatory Bowel Diseases

Extraintestinal manifestations in inflammatory bowel disease – epidemiology, genetics, and pathogenesis

Axial Spondyloarthritis in Inflammatory Bowel Diseases

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