The Incidence and Prevalence of Human Papilloma Virus–associated Cancers in IBD

2020 ◽  
Vol 27 (1) ◽  
pp. 34-39 ◽  
Author(s):  
Jonathan P Segal ◽  
Alan Askari ◽  
Susan K Clark ◽  
Ailsa L Hart ◽  
Omar D Faiz
Keyword(s):  
Inflammatory Bowel Disease ◽  
Human Papilloma Virus ◽  
Anal Cancer ◽  
Bowel Disease ◽  
Cox Regression ◽  
Population Data ◽  
Population Based ◽  
Papilloma Virus ◽  
Cox Regression Analysis ◽  
Inflammatory Bowel

Abstract Aim The human papilloma virus has been associated with anal, cervical, vaginal, and penile cancers. The primary aim of this population-based study is to determine whether HPV-associated cancers are more commonplace in patients with inflammatory bowel disease (IBD). Method The Hospital Episode Statistics (HES) database from 1997 to 2012, linked with officer for age standardized rates (ASR), were calculated using population data, and Cox regression analysis was used to determine whether IBD patients have poorer survival compared with non-IBD patients. Results A total of 61,648 patients were included in this study; of these, 837 patients had a preexisting diagnosis of IBD (1.4%). Inflammatory bowel disease patients had a significantly higher ASR of anal cancers than the non-IBD population: 5.5 per 100,000 in the IBD group compared with 1.8 in the non-IBD group. The IBD group was also diagnosed with anal cancers at a younger age (60 years compared with 66 years in the non-IBD group, P < 0.001). The survival of IBD patients with anal cancer was also poorer than the non-IBD group (hazard ratio, 1.32; 95% confidence interval, 1.15–1.52; P < 0.001). On average, survival was significantly shorter in the IBD group with anal cancer (46 months) compared with the non-IBD group (61 months, P < 0.001). Age standardized rates for cervical cancer was significantly higher in the IBD group (5.2 of 100,000) compared with the non-IBD group (4.6 of 100,000 P = 0.042). Conclusion Patients with IBD have a higher rate of anal cancer compared with the general population. Survival is also worse for anal cancers in the IBD group.

scholarly journals Anti-tumor necrosis factor-induced lupus in patients with inflammatory bowel disease: a hospital-based cohort study from Korea

2021 ◽  
Vol 14 ◽  
pp. 175628482199779
Author(s):  
Su Jin Choi ◽  
Soo Min Ahn ◽  
Ji Seon Oh ◽  
Seokchan Hong ◽  
Chang-Keun Lee ◽  
...  
Keyword(s):  
Risk Factors ◽  
Inflammatory Bowel Disease ◽  
Tumor Necrosis Factor ◽  
Bowel Disease ◽  
Tumor Necrosis ◽  
Cox Regression ◽  
Cox Regression Analysis ◽  
Inflammatory Bowel ◽  
Necrosis Factor ◽  
Mucocutaneous Symptoms

Background: Anti-tumor necrosis factor (TNF) agents are increasingly used for rheumatic diseases and inflammatory bowel disease (IBD), but are associated with the development of anti-TNF-induced lupus (ATIL). Nonetheless, few ATIL studies on non-Caucasian IBD patients exist. Here, we investigated the incidence, clinical features, and risk factors of ATIL in Korea. Methods: We retrospectively reviewed the medical records of IBD patients undergoing anti-TNF therapy at our tertiary IBD center between 2008 and 2020. ATIL was diagnosed as a temporal association between symptoms and anti-TNF agents, and the presence of at least one serologic and non-serologic American College of Rheumatology criterion. The risk factors for ATIL occurrence were assessed using multivariate Cox regression analysis. Results: Of 1362 IBD patients treated with anti-TNF agents, 50 (3.7%) ATIL cases were suspected, of which 14 (1.0%) received a definitive diagnosis. Arthritis and mucocutaneous symptoms were observed in 13 and 4 patients, respectively. All ATIL cases were positive for anti-nuclear and anti-dsDNA antibodies. Four patients (30.8%) improved while continuing anti-TNF therapy. At the final follow up, the ATIL group ( n = 14) had a lower IBD remission rate (30.8% versus 68.8%, p = 0.019) than the non-ATIL group ( n = 36). Ulcerative colitis and longer disease duration were associated with ATIL occurrence, with hazard ratios of 7.017 ( p = 0.005) and 1.118 ( p = 0.002), respectively. Conclusion: Although rare, ATIL is associated with poor treatment response to IBD in Korean patients. ATIL should be considered if arthritis and mucocutaneous symptoms develop during anti-TNF therapy for IBD.

Su1806 RISK OF ANAL CANCER IN PATIENTS WITH INFLAMMATORY BOWEL DISEASE: A POPULATION-BASED STUDY

2020 ◽  
Vol 158 (6) ◽  
pp. S-655-S-656
Author(s):  
Eula P. Tetangco ◽  
Mohammad Maysara Asfari ◽  
Muhammad Talal Sarmini ◽  
Supannee Rassameehiran ◽  
Pearl Princess Uy ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Anal Cancer ◽  
Bowel Disease ◽  
Population Based ◽  
Population Based Study ◽  
Inflammatory Bowel

scholarly journals Proactive Infliximab Monitoring Following Reactive Testing is Associated With Better Clinical Outcomes Than Reactive Testing Alone in Patients With Inflammatory Bowel Disease

2018 ◽  
Vol 12 (7) ◽  
pp. 804-810 ◽  
Author(s):  
Konstantinos Papamichael ◽  
Ravy K Vajravelu ◽  
Byron P Vaughn ◽  
Mark T Osterman ◽  
Adam S Cheifetz
Keyword(s):  
Inflammatory Bowel Disease ◽  
Treatment Failure ◽  
Bowel Disease ◽  
Cox Regression ◽  
Drug Discontinuation ◽  
Cox Regression Analysis ◽  
Loss Of Response ◽  
Group A ◽  
Inflammatory Bowel ◽  
Group B

Abstract Background and Aims Reactive testing has emerged as the new standard of care for managing loss of response to infliximab in inflammatory bowel disease [IBD]. Recent data suggest that proactive infliximab monitoring is associated with better therapeutic outcomes in IBD. Nevertheless, there are no data regarding the clinical utility of proactive infliximab monitoring after first reactive testing. We aimed to evaluate long-term outcomes of proactive infliximab monitoring following reactive testing compared with reactive testing alone in patients with IBD. Methods This was a retrospective multicenter cohort study of consecutive IBD patients on infliximab maintenance therapy receiving a first reactive testing between September 2006 and January 2015. Patients were divided into two groups; Group A [proactive infliximab monitoring after reactive testing] and Group B [reactive testing alone]. Patients were followed through December 2015. Time-to-event analysis for treatment failure and IBD-related surgery and hospitalization was performed. Treatment failure was defined as drug discontinuation due to either loss of response or serious adverse event. Results The study population consisted of 102 [n = 70, 69% with CD] patients [Group A, n = 33 and Group B, n = 69] who were followed for (median, interquartile range [IQR]) 2.7 [1.4–3.8] years. Multiple Cox regression analysis identified proactive following reactive TDM as independently associated with less treatment failure (hazard ratio [HR] 0.15; 95% confidence interval [CI] 0.05–0.51; p = 0.002) and fewer IBD-related hospitalizations [HR: 0.18; 95% CI 0.05–0.99; p = 0.007]. Conclusions This study showed that proactive infliximab monitoring following reactive testing was associated with greater drug persistence and fewer IBD-related hospitalizations than reactive testing alone.

Clostridioides difficile Infection in Children With Inflammatory Bowel Disease

2019 ◽  
Vol 26 (11) ◽  
pp. 1700-1706
Author(s):  
Abin Chandrakumar ◽  
Hussein Zohni ◽  
Wael El-Matary
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Cox Regression ◽  
Population Based ◽  
Incidence Rates ◽  
Categorical Variables ◽  
Fisher Exact Test ◽  
Clostridioides Difficile ◽  
Increased Risk ◽  
Inflammatory Bowel

Abstract Background The study’s objective was to investigate the incidence and risk factors associated with Clostridioides difficile (previously known as Clostridium) infection (CDI) in children with inflammatory bowel disease (IBD) in the province of Manitoba. Methods Our longitudinal population-based cohort was comprised of all children and young adults aged <17 years diagnosed with IBD in the Canadian province of Manitoba between 2011 and 2019. The diagnosis of CDI was confirmed based on the Triage C. difficile immunoassay and polymerase chain reaction assay to detect the presence of toxigenic C. difficile. The Fisher exact test was used to examine the relationship between categorical variables. A Cox regression model was used to estimate the risk of CDI development in IBD patients. Results Among 261 children with IBD, 20 (7.7%) developed CDI with an incidence rate of 5.04 cases per 1000 person-years, and the median age at diagnosis (interquartile range) was 12.96 (9.33–15.81) years. The incidence rates of CDI among UC and CD patients were 4.16 cases per 1000 person-years and 5.88 cases per 1000 person-years, respectively (P = 0.46). Compared with children without CDI, those who had CDI were at increased risk of future exposure to systemic corticosteroids (adjusted hazard ratio [aHR], 4.38; 95% confidence interval [CI], 1.46–13.10) and anti–tumor necrosis factor (anti-TNF) biologics (aHR, 3.31; 95% CI, 1.11–9.90). The recurrence rate of CDI in our pediatric IBD population was 25%. Conclusions Our findings confirm that children with IBD are at high risk of developing CDI, which may predict future escalation of IBD therapy.

scholarly journals P809 Increase of tuberculosis due to combination therapy in inflammatory bowel disease: a nationwide population-based study in Korea

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S632-S632
Author(s):  
S J Choi ◽  
E S Kim ◽  
J M Lee ◽  
H S Choi ◽  
B Keum ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Combination Therapy ◽  
Tumour Necrosis Factor ◽  
Bowel Disease ◽  
Tumour Necrosis ◽  
Large Population ◽  
Population Data ◽  
Population Based ◽  
Inflammatory Bowel ◽  
Necrosis Factor

Abstract Background Recent researches reported that inflammatory bowel disease (IBD) in Asia has become more prevalent. Since IBD is chronic inflammation disorder and its relapse is frequent, obtaining and maintaining remission is important. As our knowledge on the pathogenesis of IBD deepened, many immunosuppressants and biological agents were introduced and confirmed to be both safe and effective. However, biologics known as anti-tumour necrosis factor (anti-TNF) agents was reported to lose response over time in 23–46% of patients. Therefore, combination therapy adding immunomodulator drug such as azathioprine was introduced and showed better outcome by optimising biologic pharmacokinetics and minimising immunogenicity. Adversely, rates of tuberculosis are increased, but there is no large population data estimating and comparing these risk in combination therapy. Methods We used 2008–2016 data of the South Korean Health Insurance and Review Agency (HIRA), and odd ratio (OR) for tuberculosis in IBD patients who underwent anti-tumour necrosis factor (TNF) agent, azathioprine, or combination therapy. Results Between 2008 and 2016, 47,760 patients were newly diagnosed as IBD, 29,440 as UC and 15,320 as CD. We compared the risk of tuberculosis according to the medication divided into 5 groups; infliximab only, azathioprine only, combination of azathioprine and infliximab, azathioprine monotherapy and infliximab monotherapy, and azathioprine and infliximab whether simultaneously or separately. We also compared the risk between male and female. Hazard ratio of tuberculosis in infliximab monotherapy, azathioprine, and combination therapy in IBD patients were 1.132, 1.256, and 2.118, respectively. Conclusion Our study shows that Korean IBD patients are at risk for tuberculosis, and this results may highlight the importance of screening for tuberculosis in IBD patients.

scholarly journals Human Papilloma Virus Awareness Among Hispanic Females with Inflammatory Bowel Disease

2015 ◽  
Vol 3 (1) ◽  
pp. 55-62 ◽  
Author(s):  
José E. Rivera-Acosta ◽  
Maysabel Aponte ◽  
Irene Villamil ◽  
Josefina Romaguera ◽  
Ana P. Ortiz ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Human Papilloma Virus ◽  
Bowel Disease ◽  
Papilloma Virus ◽  
Hispanic Females ◽  
Inflammatory Bowel

scholarly journals P607 The Faroese IBD Study: Update on incidence from 2015–2020 and prevalence from 1960–2020

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S552-S553
Author(s):  
K R Nielsen ◽  
J Midjord ◽  
T Hammer ◽  
S Lophaven ◽  
J Burisch
Keyword(s):  
Inflammatory Bowel Disease ◽  
Incidence Rate ◽  
Bowel Disease ◽  
Age Groups ◽  
Population Data ◽  
Population Based ◽  
Point Prevalence ◽  
Faroe Islands ◽  
European Standard Population ◽  
Inflammatory Bowel

Abstract Background Previous reports have found that the Faroe Islands has the highest reported incidence of inflammatory bowel disease (IBD) in the world.1,2 The purpose of this study was to update our previous work on the IBD incidence from 1960–20142 with data up until 2020 and to describe the prevalence of IBD over 60 years. Methods All cases of Crohn’s disease (CD), ulcerative colitis (UC) and IBD unclassified (IBDU) diagnosed between 1960 to 2020, including all age groups and year of death, were retrieved from the Medical Centre at the National Hospital of the Faroe Islands. Diagnoses were ascertained according to the Copenhagen Diagnostic Criteria. Population data from 1960–2020 were retrieved from Statistics Denmark and Statistics Faroe Islands. Point prevalence rates (per 100,000) were estimated as all IBD patients alive and living in the Faroe Islands by the end of 1960, 1970, 1980, 1990, 2000, 2010 and 2020, divided by the Faroese population (end of year). Results 232 individuals have been diagnosed with IBD during the past 6 years in the Faroe Islands: 29 (12%) with CD, 111 (48%) with UC and 92 (40%) with IBDU, resulting in an increased age-standardised IBD incidence rate (European Standard Population, ESP) from 74 per 100,000 person-years (py) in 2010–14 to 80 in 2015–20. Figure 1 illustrates the updated IBD incidence rate integrated with results from our previous study.2 The point prevalence rate of IBD was 5,8 cases per 100,000 persons in 1960; 46,6 in 1970; 133,9 in 1980; 325,4 in 1990; 610,7 in 2000; 925,1 in 2010 and 1407,9 cases per 100,000 in 2020, corresponding to 1,4% of the Faroese population living with IBD in 2020 compared to 0,6% in 2000. Conclusion The increasing incidence of IBD from 2015–2020 is mainly driven by IBDU, accounting for 40% of all cases and has increased from 21 per 100,000 (ESP) in 2010–14 to 32 in 2015–2020. The age-standardised incidence rate of CD remains unchanged compared to our previous study, at 10 per 100,000 (ESP), while the incidence of UC has decreased from 44 to 39 per 100,000 (ESP). The prevalence of IBD has increased radically in accordance with the increasing incidence. Further investigations into the high proportion of IBDU and causes of the observed IBD pattern is currently ongoing. 1. Ng SC, Shi HY, Hamidi N, et al. Worldwide incidence and prevalence of inflammatory bowel disease in the 21st century: a systematic review of population-based studies. Lancet 2018;390:2769–78.et al. 2. The Faroese IBD Study: Incidence of Inflammatory Bowel Diseases Across 54 Years of Population-based Data. J Crohns Colitis 2016;10:934–42.

scholarly journals P777 Clostridioides difficile infection in children with inflammatory bowel disease: A Canadian population-based study

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S616-S616
Author(s):  
W El-Matary ◽  
A Chandrakumar ◽  
H Zohni
Keyword(s):  
Inflammatory Bowel Disease ◽  
Incidence Rate ◽  
Bowel Disease ◽  
Cox Regression ◽  
Population Based ◽  
Categorical Variables ◽  
Clostridioides Difficile ◽  
Increased Risk ◽  
Clostridioides Difficile Infection ◽  
Inflammatory Bowel

Abstract Background Toxigenic Clostridioides difficile (C. difficile), previously known as Clostridium difficile, is an anaerobic gram-positive spore-forming opportunistic pathogen associated with profuse diarrhoea and gastroenteritis associated mortality, especially in children with inflammatory bowel disease (IBD). The aim of this work was to investigate the incidence and risk factors associated with Clostridioides difficile infection (CDI) in children with IBD in the province of Manitoba, Canada. Methods Our longitudinal population-based cohort comprised of all children and young adults <17 years diagnosed with IBD in the Canadian province of Manitoba between 2011 and 2019. The diagnosis of CDI was confirmed based on the Triage C. difficile immunoassay and polymerase chain reaction assay to detect the presence of toxigenic C. difficile. Fisher’s exact test was used to examine the relationship between categorical variables. Cox-regression model was used to estimate the risk of CDI development in IBD patients. Results Among the 261 children with IBD, 20 (7.7%) developed CDI with an incidence rate of 5.04 cases per 1000 person-years and the median age at diagnosis of 12.96 years (IQR: 9.33–15.81). The incidence rate of CDI among UC and CD patients were 4.16 cases per 1000 person-years and 5.88 cases per 1000 person-years, respectively (p = 0.46). Compared to children without CDI, those who had CDI were at increased risk of future exposure to systemic corticosteroids (hazard ratio (HR) = 4.30; 95% CI: 1.44–12.87) and anti-tumour necrosis factor (TNF) biologics (HR = 3.37; 95% CI: 1.13–10.09). Recurrence rate of CDI in our paediatric IBD population was 25%. Conclusion Our findings confirm that children with IBD are at a high risk of developing CDI, which may predict future escalation of IBD therapy.

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