14-fold rise in infection risk from strong IBD treatment

Patients aged 50 are three times more likely to develop infections.

Patients with inflammatory bowel disease (IBD) who take multiple immunosuppressants are up to 14 times more likely to develop infections than patients who do not use the drugs, US research suggests.

NICE guidance recommends that immunosuppressants be used to control inflammation in those suffering from IBD.

For the latest study researchers examined the medical records of 300 IBD patients, 100 of who had contracted opportunistic infections arising from viral, fungal, bacterial and mycobacterial organisms.

Among the 300 patients, 133 were taking at least one immunosuppressant and 36 were taking two or more.

The researchers found that patients taking one immunosuppressive medication, corticosteroid, azathioprine or infliximab, were three times more likely to develop opportunistic infections than those prescribed none.

However, patients taking two or three immunosuppressants were 14 times more likely to develop infections than those taking none.

Patients aged 50 and older were also three times more likely to develop infections than younger patients.

Lead researcher Dr Edward Loftus, a gastroenterologist from the Mayo Clinic in Minnesota, said: 'Treatment with immunosuppressive medications could compromise the immune system leading to infections that would not affect individuals with healthy immune systems.'

Previous research has suggested that immunosuppressants could reactivate latent TB, he said.

'This is an example of the need to be aware of the risks of combination immunosuppressive therapies,' added Dr Loftus.

sanjay.tanday@haymarket.com

Gastroenterology 2008; 134: 929-36

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