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Patients with inflammatory bowel disease may be at increased risk for infections. Dr Millie Long and colleagues determined the pneumonia risk in inflammatory bowel disease and how specific medications affect this risk. The researchers performed a retrospective cohort and a nested case–control study using administrative data from IMS Health Inc., LifeLink Health Plan Claims Database. The team reported that limitations to this data set include lack of clinical details to validate exposures and outcomes. The team of doctors evaluated pneumonia risk by incidence rate ratio and adjusted Cox proportional hazards models. In the nested case–control, 4,856 inflammatory bowel disease patients with pneumonia were matched to 4 inflammatory bowel disease patients without pneumonia by incidence density sampling.  | | Medications such as corticosteroids are associated with pneumonia in IBD | | American Journal of Gastroenterology |
The research team used conditional logistic regression to determine the associations between medications and pneumonia. The cohort included 50,932 patients with Crohn's disease, 56,403 patients with ulcerative colitis, and 1,269 with unspecified inflammatory bowel disease, matched to 434,416 individuals without inflammatory bowel disease . The team of doctors noted that median follow-up within the cohort was 24 months. The inflammatory bowel disease cohort had an increased pneumonia risk when compared with non-inflammatory bowel disease. After adjustments, the researchers noted that pneumonia risk remained increased for the inflammatory bowel disease vs. non- inflammatory bowel disease cohort, with increased risk in both Crohn's disease and ulcerative colitis. In the nested case–control analysis, use of biologic medications, corticosteroids, thiopurines, proton-pump inhibitors, or narcotics was independently associated with pneumonia. Dr Long's team concluded, "Patients with inflammatory bowel disease are at increased risk for pneumonia." "Medications such as corticosteroids and narcotics are particularly associated with pneumonia in this population." "An emphasis upon primary prevention of pneumonia through vaccination and reduction of risk factors is warranted."
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