Risk of incident Mycobacterium tuberculosis infection in patients with inflammatory bowel disease

a nationwide population-based study in South Korea

S. N. Hong, H. J. Kim, K. H. Kim, S. J. Han, I. M. Ahn, Hyeong Sik Ahn

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background: The low incidence of Mycobacterium tuberculosis infection and lack of adequate controls have prevented researchers from estimating tuberculosis (TB) risk in inflammatory bowel disease (IBD) patients. Aim: To evaluate the risk of incident TB among IBD patients. Methods: Using the 2011–2013 data of the South Korean National Health Insurance (NHI) system, we calculated the incidence rates (IRs), standardised incidence ratio (SIR) and number needed to screen (NNS) for incident TB in IBD patients compared to the general population in terms of subtype, age, gender and IBD medications. Results: The IR, SIR and NNS for TB in IBD patients were 223.9/100 000 person-years, 2.64 (2.30–3.01) and 446.6 (392.8–517.6), respectively. The TB IR in Crohn's disease (CD) patients was significantly higher than that in ulcerative colitis (UC) patients (340.1/100 000 person-years vs. 165.5/100 000 person-years, respectively; P < 0.001). The SIR and NNS for TB among CD patients were 4.00 (3.59–4.45) and 604.2 (506.1–749.6), respectively; those among UC patients were 1.95 (1.66–2.27) and 294.0 (246.9–363.4). The TB IRs in IBD patients did not differ significantly by age or gender (Ptrend = 0.505 and P = 0.861, respectively). The TB IRs among IBD patients prescribed 5-ASA, corticosteroids, immunomodulators and anti-TNF-α were 143.5, 208.5, 284.6 and 554.1 per 100 000 person-years, respectively. Among IBD patients treated using anti-TNF-α, the TB IR was significantly higher than that among all IBD patients (P < 0.001); the SIR and NNS for TB were 6.53 (5.99–7.09) and 180.5 (144.6–240.1) respectively. Conclusion: Clinicians should be aware of the increased risk of active tuberculosis in patients with IBD who are receiving anti-TNF-α therapy.

Original languageEnglish
Pages (from-to)253-263
Number of pages11
JournalAlimentary Pharmacology and Therapeutics
Volume45
Issue number2
DOIs
Publication statusPublished - 2017 Jan 1

Fingerprint

Republic of Korea
Mycobacterium Infections
Inflammatory Bowel Diseases
Mycobacterium tuberculosis
Tuberculosis
Incidence
Population
Ulcerative Colitis
Crohn Disease
Immunologic Factors
National Health Programs
Adrenal Cortex Hormones

ASJC Scopus subject areas

  • Pharmacology (medical)

Cite this

Risk of incident Mycobacterium tuberculosis infection in patients with inflammatory bowel disease : a nationwide population-based study in South Korea. / Hong, S. N.; Kim, H. J.; Kim, K. H.; Han, S. J.; Ahn, I. M.; Ahn, Hyeong Sik.

In: Alimentary Pharmacology and Therapeutics, Vol. 45, No. 2, 01.01.2017, p. 253-263.

Research output: Contribution to journalArticle

@article{3244fae96e054c3ebb7e030785411c86,
title = "Risk of incident Mycobacterium tuberculosis infection in patients with inflammatory bowel disease: a nationwide population-based study in South Korea",
abstract = "Background: The low incidence of Mycobacterium tuberculosis infection and lack of adequate controls have prevented researchers from estimating tuberculosis (TB) risk in inflammatory bowel disease (IBD) patients. Aim: To evaluate the risk of incident TB among IBD patients. Methods: Using the 2011–2013 data of the South Korean National Health Insurance (NHI) system, we calculated the incidence rates (IRs), standardised incidence ratio (SIR) and number needed to screen (NNS) for incident TB in IBD patients compared to the general population in terms of subtype, age, gender and IBD medications. Results: The IR, SIR and NNS for TB in IBD patients were 223.9/100 000 person-years, 2.64 (2.30–3.01) and 446.6 (392.8–517.6), respectively. The TB IR in Crohn's disease (CD) patients was significantly higher than that in ulcerative colitis (UC) patients (340.1/100 000 person-years vs. 165.5/100 000 person-years, respectively; P < 0.001). The SIR and NNS for TB among CD patients were 4.00 (3.59–4.45) and 604.2 (506.1–749.6), respectively; those among UC patients were 1.95 (1.66–2.27) and 294.0 (246.9–363.4). The TB IRs in IBD patients did not differ significantly by age or gender (Ptrend = 0.505 and P = 0.861, respectively). The TB IRs among IBD patients prescribed 5-ASA, corticosteroids, immunomodulators and anti-TNF-α were 143.5, 208.5, 284.6 and 554.1 per 100 000 person-years, respectively. Among IBD patients treated using anti-TNF-α, the TB IR was significantly higher than that among all IBD patients (P < 0.001); the SIR and NNS for TB were 6.53 (5.99–7.09) and 180.5 (144.6–240.1) respectively. Conclusion: Clinicians should be aware of the increased risk of active tuberculosis in patients with IBD who are receiving anti-TNF-α therapy.",
author = "Hong, {S. N.} and Kim, {H. J.} and Kim, {K. H.} and Han, {S. J.} and Ahn, {I. M.} and Ahn, {Hyeong Sik}",
year = "2017",
month = "1",
day = "1",
doi = "10.1111/apt.13851",
language = "English",
volume = "45",
pages = "253--263",
journal = "Alimentary Pharmacology and Therapeutics",
issn = "0269-2813",
publisher = "Wiley-Blackwell",
number = "2",

}

TY - JOUR

T1 - Risk of incident Mycobacterium tuberculosis infection in patients with inflammatory bowel disease

T2 - a nationwide population-based study in South Korea

AU - Hong, S. N.

AU - Kim, H. J.

AU - Kim, K. H.

AU - Han, S. J.

AU - Ahn, I. M.

AU - Ahn, Hyeong Sik

PY - 2017/1/1

Y1 - 2017/1/1

N2 - Background: The low incidence of Mycobacterium tuberculosis infection and lack of adequate controls have prevented researchers from estimating tuberculosis (TB) risk in inflammatory bowel disease (IBD) patients. Aim: To evaluate the risk of incident TB among IBD patients. Methods: Using the 2011–2013 data of the South Korean National Health Insurance (NHI) system, we calculated the incidence rates (IRs), standardised incidence ratio (SIR) and number needed to screen (NNS) for incident TB in IBD patients compared to the general population in terms of subtype, age, gender and IBD medications. Results: The IR, SIR and NNS for TB in IBD patients were 223.9/100 000 person-years, 2.64 (2.30–3.01) and 446.6 (392.8–517.6), respectively. The TB IR in Crohn's disease (CD) patients was significantly higher than that in ulcerative colitis (UC) patients (340.1/100 000 person-years vs. 165.5/100 000 person-years, respectively; P < 0.001). The SIR and NNS for TB among CD patients were 4.00 (3.59–4.45) and 604.2 (506.1–749.6), respectively; those among UC patients were 1.95 (1.66–2.27) and 294.0 (246.9–363.4). The TB IRs in IBD patients did not differ significantly by age or gender (Ptrend = 0.505 and P = 0.861, respectively). The TB IRs among IBD patients prescribed 5-ASA, corticosteroids, immunomodulators and anti-TNF-α were 143.5, 208.5, 284.6 and 554.1 per 100 000 person-years, respectively. Among IBD patients treated using anti-TNF-α, the TB IR was significantly higher than that among all IBD patients (P < 0.001); the SIR and NNS for TB were 6.53 (5.99–7.09) and 180.5 (144.6–240.1) respectively. Conclusion: Clinicians should be aware of the increased risk of active tuberculosis in patients with IBD who are receiving anti-TNF-α therapy.

AB - Background: The low incidence of Mycobacterium tuberculosis infection and lack of adequate controls have prevented researchers from estimating tuberculosis (TB) risk in inflammatory bowel disease (IBD) patients. Aim: To evaluate the risk of incident TB among IBD patients. Methods: Using the 2011–2013 data of the South Korean National Health Insurance (NHI) system, we calculated the incidence rates (IRs), standardised incidence ratio (SIR) and number needed to screen (NNS) for incident TB in IBD patients compared to the general population in terms of subtype, age, gender and IBD medications. Results: The IR, SIR and NNS for TB in IBD patients were 223.9/100 000 person-years, 2.64 (2.30–3.01) and 446.6 (392.8–517.6), respectively. The TB IR in Crohn's disease (CD) patients was significantly higher than that in ulcerative colitis (UC) patients (340.1/100 000 person-years vs. 165.5/100 000 person-years, respectively; P < 0.001). The SIR and NNS for TB among CD patients were 4.00 (3.59–4.45) and 604.2 (506.1–749.6), respectively; those among UC patients were 1.95 (1.66–2.27) and 294.0 (246.9–363.4). The TB IRs in IBD patients did not differ significantly by age or gender (Ptrend = 0.505 and P = 0.861, respectively). The TB IRs among IBD patients prescribed 5-ASA, corticosteroids, immunomodulators and anti-TNF-α were 143.5, 208.5, 284.6 and 554.1 per 100 000 person-years, respectively. Among IBD patients treated using anti-TNF-α, the TB IR was significantly higher than that among all IBD patients (P < 0.001); the SIR and NNS for TB were 6.53 (5.99–7.09) and 180.5 (144.6–240.1) respectively. Conclusion: Clinicians should be aware of the increased risk of active tuberculosis in patients with IBD who are receiving anti-TNF-α therapy.

UR - http://www.scopus.com/inward/record.url?scp=84998537712&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84998537712&partnerID=8YFLogxK

U2 - 10.1111/apt.13851

DO - 10.1111/apt.13851

M3 - Article

VL - 45

SP - 253

EP - 263

JO - Alimentary Pharmacology and Therapeutics

JF - Alimentary Pharmacology and Therapeutics

SN - 0269-2813

IS - 2

ER -