#Dipeptidyl peptidase-4 inhibitors and incidence of inflammatory #bowel disease among patients with type 2 #diabetes: population based cohort study

http://www.bmj.com/content/360/bmj.k872

During 552 413 person years of follow-up, 208 incident inflammatory bowel disease events occurred (crude incidence rate of 37.7 (95% confidence interval 32.7 to 43.1) per 100 000 person years). Overall, use of dipeptidyl peptidase-4 inhibitors was associated with an increased risk of inflammatory bowel disease (53.4 v 34.5 per 100 000 person years; hazard ratio 1.75, 95% confidence interval 1.22 to 2.49). Hazard ratios gradually increased with longer durations of use, reaching a peak after three to four years of use (hazard ratio 2.90, 1.31 to 6.41) and decreasing after more than four years of use (1.45, 0.44 to 4.76). A similar pattern was observed with time since starting dipeptidyl peptidase-4 inhibitors. These findings remained consistent in several sensitivity analyses.

Conclusions In this first population based study, the use of dipeptidyl peptidase-4 inhibitors was associated with an increased risk of inflammatory bowel disease. Although these findings need to be replicated, physicians should be aware of this possible association

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Inflammatory #bowel disease increases the risk of #Parkinson’s disease: a Danish nationwide cohort study 1977–2014

http://gut.bmj.com/content/early/2018/04/16/gutjnl-2017-315666


Patients with IBD had a 22% increased risk of PD as compared with non-IBD individuals (HR=1.22; 95% CI 1.09 to 1.35). The increased risk was present independently of age at IBD diagnosis, gender or length of follow-up. The overall incidence of MSA was low in our study, and the regression analysis suggested a tendency towards higher risk of developing MSA in patients with IBD as compared with non-IBD individuals (HR=1.41; 95% CI 0.82 to 2.44). Estimates were similar for women and men. The increased risk of parkinsonism was significantly higher among patients with UC (HR=1.35; 95% CI 1.20 to 1.52) and not significantly different among patients with Crohn’s disease (HR=1.12; 95% CI 0.89 to 1.40).

Conclusions This nationwide, unselected, cohort study shows a significant association between IBD and later occurrence of PD, which is consistent with recent basic scientific findings of a potential role of GI inflammation in development of parkinsonian disorders

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#Depression increases the risk of inflammatory #bowel disease, which may be mitigated by the use of antidepressants in the treatment of depression

https://gut.bmj.com/content/early/2018/10/18/gutjnl-2018-317182

We identified 403 665 (7.05%) patients with incident depression. Individuals with depression had a significantly greater risk of developing CD (adjusted HR=2.11, 95% CI 1.65 to 2.70) and UC (adjusted HR=2.23, 95% CI 1.92 to 2.60) after controlling for demographic and clinical covariates. SSRI and TCA were protective against CD, whereas mirtazapine, SNRI, SSRI, serotonin modulators and TCA were protective for UC.

Conclusion Patients with a history of depression were more likely to be diagnosed with IBD. In contrast, antidepressant treatments were selectively protective for Crohn’s disease and UC. These results may impact counselling and management of depression and IBD

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High Patient #Activation Is Associated With Remission in Patients With Inflammatory #Bowel Disease

https://academic.oup.com/ibdjournal/advance-article-abstract/doi/10.1093/ibd/izy378/5257738?redirectedFrom=fulltext

High levels of patient activation (having the knowledge, skills, and confidence to effectively manage one’s care), have been associated with improved outcomes in many chronic conditions. There have been few studies of the effects of activation in patients with inflammatory bowel disease (IBD). We performed a large, prospective Internet-based study to assess the relationship between patient activation level and clinical remission in patients with Crohn’s disease or ulcerative colitis.

Higher anxiety (adjusted odds ratio aOR, 0.32; 95% confidence interval CI, 0.29–0.36) and depression scores were associated with a decreased odds of high patient activation. After we adjusted for education status, smoking, medication use, and other confounders, we found that patients with high activation at baseline were more likely to be in clinical remission during the follow-up period.

In a large, prospective Internet-based cohort of patients with IBD, we found a strong association between patient activation and clinical remission. These findings suggest that patient activation affects disease outcomes.

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Hospitalization Outcomes for #Inflammatory #Bowel Disease in Teaching vs Nonteaching Hospitals

https://academic.oup.com/ibdjournal/advance-article-abstract/doi/10.1093/ibd/izz089/5482270?redirectedFrom=fulltext

Hospitalizations contribute significantly to the annual health care expenditure for inflammatory bowel disease (IBD), and reducing cost of care without compromising outcomes is a rising priority. Teaching hospitals (THs) have higher costs and utilize trainees in care to a greater extent than community hospitals, and it is unknown how hospital teaching status (HTS) affects outcomes. We therefore sought to investigate the impact of HTS on IBD hospitalization outcomes.

Unadjusted mean LOS, mean DC, and 30-day RR were greater among THs for both UC and CD. Unadjusted MR was greater among major THs for UC but not CD. After multivariable analysis, only 30-day RR for UC was increased in major THs relative to non-THs (1.98%; 95% confidence interval, 0.33%–3.61%).

Conclusions
Differences in metrics of cost-effective hospital care for patients with IBD appear to be driven by disease severity rather than HTS. Future research should attempt to better characterize factors driving resource utilization for IBD hospitalizations.

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#Vaccine-Preventable Diseases in Hospitalized Patients With Inflammatory #Bowel Disease: A Nationwide Cohort Analysis

https://academic.oup.com/ibdjournal/advance-article-abstract/doi/10.1093/ibd/izz093/5487145?redirectedFrom=fulltext

Inflammatory bowel disease (IBD) entails a higher risk of infections, including those that could be prevented with immunizations. Current Advisory Committee on Immunization Practices and American College of Gastroenterology vaccine recommendations for patients with IBD are based on low levels of evidence.

The most common VPDs among patients with IBD were herpes zoster virus (HZV) (34.9%) and hepatitis B virus (31.6%), followed by influenza (22.1%). Pneumococcal pneumonia (9.1%) and hepatitis A virus (2.4%) were less common. Inpatients with IBD were twice as likely to have HZV when compared to non-IBD inpatients (odds ratios OR = 2.30 95% CI, 2.06–2.58, P < 0.0001) This finding was consistent for every study year. Pneumococcal pneumonia OR = 0.62 (95% CI, 0.52–0.74), P < 0.0001 and influenza OR = 0.72 (95% CI, 0.63–0.81), P < 0.0001 were significantly lower in the IBD population. There was no difference for other VPDs.

Conclusions
HZV was the most frequent VPD in IBD inpatients. Patients with IBD have a higher rate of hospital admissions with HZV and a lower rate of pneumococcal pneumonia and influenza admissions when compared with non-IBD patients. For other VPDs, patients with IBD have the same rate of admission as the general population.

Are Patients With Inflammatory Bowel Disease at an Increased Risk of Developing #SARS-CoV-2 than Patients Without Inflammatory #Bowel Disease? Results From a Nationwide Veterans’ Affairs Cohort Study
https://2medical.news/2021/01/30/are-patients-with-inflammatory-bowel-disease-at-an-increased-risk-of-developing-sars-cov-2-than-patients-without-inflammatory-bowel-disease-results-from-a-nationwide-veterans-affairs-cohort-study/

The clinic course of SARS-CoV-2 among patients with inflammatory bowel disease (IBD) has been extensively studied. However, there is a paucity of data on whether patients with IBD have an increased risk of developing SARS-CoV-2 with compared with patients without IBD. METHODS: We conducted a nationwide retrospective cohort study in the US Veterans’ Affairs healthcare system from January 1, 2020, to June 30, 2020. We …

Risk of #Inflammatory #Bowel Disease in Patients With #Atopic Dermatitis

https://2medical.news/2023/09/16/risk-of-inflammatory-bowel-disease-in-patients-with-atopic-dermatitis/

Examining the Association between #Coffee Intake and the Risk of Developing #Irritable #Bowel Syndrome: A Systematic Review and Meta-Analysis

https://2medical.news/2023/12/05/examining-the-association-between-coffee-intake-and-the-risk-of-developing-irritable-bowel-syndrome-a-systematic-review-and-meta-analysis/

#Migraine is associated with the development of adult patients with inflammatory #bowel disease: a nationwide, population-based study

https://2medical.news/2024/02/01/migraine-is-associated-with-the-development-of-adult-patients-with-inflammatory-bowel-disease-a-nationwide-population-based-study/