Increasing Prescription of #Opiates and Mortality in Patients with Inflammatory Bowel Diseases in England
http://www.cghjournal.org/article/S1542-3565(17)31247-8/fulltext
The prescription of opiate medications is increasing. Individuals with inflammatory bowel diseases (#IBD) can develop serious complications from opiate use, but few data are available on the prescription of these drugs to patients with IBD. We examined trends in prescriptions of opiates and their association with all-cause mortality in individuals with IBD
There was a statistically significant increase in the prescription of opiate medications with 10% of subjects receiving an opiate prescription during the years 1990 through 1993 compared to 30% in 2010 through 2013 (chi2 for trend, P<.005). Prescription of strong opiates was significantly associated with increased premature mortality of patients with CD (heavy use) or UC (moderate or heavy use). There was a similar, significant association for the heavy use of any opiate or codeine used alone in those with a diagnosis of UC. Use of tramadol alone, or in combination with codeine, was not associated with premature mortality in either CD or UC.
Conclusion
In an analysis of primary care patients with IBD in England, we found prescriptions for opiate drugs to have increased significantly from 1990 through 2013. Heavy use of strong opiates among patients with IBD was associated with increased all-cause premature mortality. Residual confounding variables might account for observed associations. The adverse effects of opiate medications for non-cancer pain have been established; we now associate their use with increased all-cause premature mortality in individuals with IBD
http://www.cghjournal.org/article/S1542-3565(17)31247-8/fulltext
The prescription of opiate medications is increasing. Individuals with inflammatory bowel diseases (#IBD) can develop serious complications from opiate use, but few data are available on the prescription of these drugs to patients with IBD. We examined trends in prescriptions of opiates and their association with all-cause mortality in individuals with IBD
There was a statistically significant increase in the prescription of opiate medications with 10% of subjects receiving an opiate prescription during the years 1990 through 1993 compared to 30% in 2010 through 2013 (chi2 for trend, P<.005). Prescription of strong opiates was significantly associated with increased premature mortality of patients with CD (heavy use) or UC (moderate or heavy use). There was a similar, significant association for the heavy use of any opiate or codeine used alone in those with a diagnosis of UC. Use of tramadol alone, or in combination with codeine, was not associated with premature mortality in either CD or UC.
Conclusion
In an analysis of primary care patients with IBD in England, we found prescriptions for opiate drugs to have increased significantly from 1990 through 2013. Heavy use of strong opiates among patients with IBD was associated with increased all-cause premature mortality. Residual confounding variables might account for observed associations. The adverse effects of opiate medications for non-cancer pain have been established; we now associate their use with increased all-cause premature mortality in individuals with IBD
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Epidemiology and implications of concurrent diagnosis of #eosinophilic oesophagitis and #IBD based on a prospective population-based analysis
https://gut.bmj.com/content/early/2019/03/28/gutjnl-2018-318074
Eosinophilic oesophagitis (EoO) and IBD are immune-mediated diseases of the gastrointestinal tract with possible overlapping pathogenic mechanisms. Our aim was to define the epidemiology and clinical implications of concurrent EoO and IBD diagnoses.
Among 134 013 536 individuals, the incidence of EoO, CD and UC were 23.1, 51.2 and 55.2 per 100 000 person-years, respectively. The risk of EoO was higher among patients with CD (incidence rate ratio IRR 5.4, p<0.01; prevalence ratio (PR) 7.8, p<0.01) or UC (IRR 3.5, p<0.01; PR 5.0, p<0.01), while the risk of IBD was higher among patients with EoO (CD: IRR 5.7, p<0.01; PR 7.6, p<0.01; UC: IRR 3.4, p<0.01; PR 4.9, p<0.01) versus individuals without either diagnosis. Concurrent diagnosis of EoO and IBD was associated with greater composite risk of IBD-related complications (CD: adjusted HR (aHR) 1.09, p=0.01; UC: aHR 1.10, p=0.04) but lower composite risk of EoO-related complications (aHR 0.59; p<0.01).
Conclusion Based on a population-based prospective cohort analysis, the risk of EoO is significantly higher among patients with IBD and vice versa. Concurrent diagnoses might modify the risk of IBD-related and EoO-related complications. Studies defining the mechanisms underlying these observations are needed.
Epidemiology and implications of concurrent diagnosis of #eosinophilic oesophagitis and #IBD based on a prospective population-based analysis
https://gut.bmj.com/content/early/2019/03/28/gutjnl-2018-318074
Eosinophilic oesophagitis (EoO) and IBD are immune-mediated diseases of the gastrointestinal tract with possible overlapping pathogenic mechanisms. Our aim was to define the epidemiology and clinical implications of concurrent EoO and IBD diagnoses.
Among 134 013 536 individuals, the incidence of EoO, CD and UC were 23.1, 51.2 and 55.2 per 100 000 person-years, respectively. The risk of EoO was higher among patients with CD (incidence rate ratio IRR 5.4, p<0.01; prevalence ratio (PR) 7.8, p<0.01) or UC (IRR 3.5, p<0.01; PR 5.0, p<0.01), while the risk of IBD was higher among patients with EoO (CD: IRR 5.7, p<0.01; PR 7.6, p<0.01; UC: IRR 3.4, p<0.01; PR 4.9, p<0.01) versus individuals without either diagnosis. Concurrent diagnosis of EoO and IBD was associated with greater composite risk of IBD-related complications (CD: adjusted HR (aHR) 1.09, p=0.01; UC: aHR 1.10, p=0.04) but lower composite risk of EoO-related complications (aHR 0.59; p<0.01).
Conclusion Based on a population-based prospective cohort analysis, the risk of EoO is significantly higher among patients with IBD and vice versa. Concurrent diagnoses might modify the risk of IBD-related and EoO-related complications. Studies defining the mechanisms underlying these observations are needed.
Outcomes of COVID-19 in 79 patients with #IBD in Italy: an IG-IBD study
https://2medical.news/2020/05/27/outcomes-of-covid-19-in-79-patients-with-ibd-in-italy-an-ig-ibd-study/
COVID-19 has rapidly become a major health emergency worldwide. Patients with IBD are at increased risk of infection, especially when they have active disease and are taking immunosuppressive therapy. The characteristics and outcomes of COVID-19 in patients with IBD remain unclear.. ..Between 11 and 29 March 2020, 79 patients with IBD with COVID-19 were enrolled at 24 IBD referral units. Thirty-six patients had COVID-19-related pneumonia …
https://2medical.news/2020/05/27/outcomes-of-covid-19-in-79-patients-with-ibd-in-italy-an-ig-ibd-study/
COVID-19 has rapidly become a major health emergency worldwide. Patients with IBD are at increased risk of infection, especially when they have active disease and are taking immunosuppressive therapy. The characteristics and outcomes of COVID-19 in patients with IBD remain unclear.. ..Between 11 and 29 March 2020, 79 patients with IBD with COVID-19 were enrolled at 24 IBD referral units. Thirty-six patients had COVID-19-related pneumonia …
High-Fat Diet and Antibiotics Cooperatively Impair Mitochondrial Bioenergetics to Trigger #Dysbiosis that Exacerbates Pre-inflammatory Bowel Disease
https://2medical.news/2020/07/21/high-fat-diet-and-antibiotics-cooperatively-impair-mitochondrial-bioenergetics-to-trigger-dysbiosis-that-exacerbates-pre-inflammatory-bowel-disease/
The clinical spectra of irritable bowel syndrome (#IBS) and inflammatory bowel disease (#IBD) intersect to form a scantily defined overlap syndrome, termed pre-IBD. We show that increased Enterobacteriaceae and reduced Clostridia abundance distinguish the fecal microbiota of pre-IBD patients from IBS patients. A history of antibiotics in individuals consuming a high-fat diet was associated with the greatest risk for pre-IBD. Exposing mice to these risk …
https://2medical.news/2020/07/21/high-fat-diet-and-antibiotics-cooperatively-impair-mitochondrial-bioenergetics-to-trigger-dysbiosis-that-exacerbates-pre-inflammatory-bowel-disease/
The clinical spectra of irritable bowel syndrome (#IBS) and inflammatory bowel disease (#IBD) intersect to form a scantily defined overlap syndrome, termed pre-IBD. We show that increased Enterobacteriaceae and reduced Clostridia abundance distinguish the fecal microbiota of pre-IBD patients from IBS patients. A history of antibiotics in individuals consuming a high-fat diet was associated with the greatest risk for pre-IBD. Exposing mice to these risk …