TOPLINE:
Histologic inflammation in patients with inflammatory bowel disease (IBD) raises the risk of serious infection, even during periods of apparent low disease activity, highlighting the importance of achieving histologic remission with a fully healed intestinal mucosa, researchers say.
METHODOLOGY:
National population-based study of 55,626 adults diagnosed with IBD in 1990-2016 with longitudinal data on ileo-colorectal biopsies followed through 2016. About two thirds had ulcerative colitis and one third had Crohn's disease.
Cox regression was used to estimate hazard ratios (HRs) for serious infections requiring hospitalization in the 12 months following documentation of histologic inflammation (vs histologic remission).
Analyses were adjusted for social and demographic factors, chronic comorbidities, prior IBD-related surgery and hospitalization, and IBD-related medications.
TAKEAWAY:
With histologic inflammation, there were 4.62 serious infections per 100 person-years of follow-up versus 2.53 per 100 person-years of follow-up with histologic remission (adjusted HR, 1.59; 95% CI, 1.48 - 1.72).
Histologic inflammation was associated with an increased risk of serious infections in both ulcerative colitis (aHR, 1.68; 95% CI, 1.51 - 1.87) and Crohn's disease (aHR, 1.59; 95% CI, 1.40 - 1.80) compared with histologic remission.
Histologic inflammation was associated with an increased risk for sepsis(aHR, 1.66; 95% CI, 1.28 - 2.15) and opportunistic infections (aHR, 1.71; 95% CI, 1.22 - 2.41).
