Increased Risk of Influenza and Influenza-Related Complications Among 140,480 Patients With Inflammatory Bowel Disease
Increased Risk of Influenza and Influenza-Related Complications Among 140,480 Patients With Inflammatory Bowel Disease
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DOI：
10.1093/ibd/izy243
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发表时间：
2019-02-01
影响因子：
4.9
通讯作者：
Clarke, Kofi
中科院分区：
文献类型：
--
作者：
Tinsley, Andrew;Navabi, Seyedehsan;Clarke, Kofi
免疫失调疾病与病毒感染风险增加有关，其中一些可能是可以预防的。到目前为止，有关炎症性肠病(IBD)患者流感及其相关并发症的发病率和风险的数据非常有限。此外，免疫抑制药物对这种风险的影响尚不清楚。因此，这项研究的目的是估计IBD患者中流感感染的发生率和严重程度。此外，我们特别观察了药物对流感风险的影响。利用MarketScan数据库(2008年1月至2011年12月)，我们进行了一项回顾性队列研究，以估计IBD患者与非IBD患者相比的流感发病率和相关并发症的风险。我们采用嵌套式病例对照研究设计来评估IBD药物对流感风险的潜在独立影响。总共有140,480名IBD患者和非IBD对照患者被研究。有2963名流感患者与1941名非IBD患者相比。炎症性肠病患者与非炎症性肠病患者相比，流感风险增加(发病率比，1.54；95%可信区间，1.491.63)。住院率较高(1 162/2 994[5.4%]对36/1 941[1.85%]；P<；0.001)。全身皮质类固醇激素与流感独立相关(优势比1.22；95%可信区间1.081.38)。与非IBD患者相比，炎症性肠病患者患流感的风险更高，更有可能需要住院治疗。类固醇是唯一与流感风险独立相关的药物类别。
Diseases of immune dysregulation are associated with an increased risk of viral infections, some of which may be preventable. To date, there are very limited data on the incidence and risk of influenza and related complications in patients with inflammatory bowel disease (IBD). Furthermore, the impact of immunosuppressive medications on that risk is unclear. Therefore, the aim of this study was to estimate the incidence and severity of influenza infections in IBD patients. In addition, we looked specifically at the effect of medications on influenza risk.Using the MarketScan Database (January 2008 to December 2011), we conducted a retrospective cohort study to estimate the incidence of influenza and risk of related complications in IBD patients compared with those without IBD. We employed a nested casecontrol study design to evaluate the potential independent effect of IBD medications on influenza risk.A total of 140,480 patients with IBD and non-IBD controls were studied. There were 2963 patients with influenza compared with 1941 non-IBD subjects. Inflammatory bowel disease patients had an increased influenza risk compared with those without IBD (incidence rate ratio, 1.54; 95% confidence interval [CI], 1.491.63). A higher rate of hospitalizations (162/2994 [5.4%] vs 36/1941 [1.85%]; P < 0.001) was noted. Systemic corticosteroids were found to be independently associated with influenza (odds ratio, 1.22; 95% CI, 1.081.38).Inflammatory bowel disease patients had an increased risk of influenza compared with those without IBD and were more likely to require hospitalization. Steroids were the only medication class independently associated with flu risk.