Premium
Idiopathic inflammatory demyelinating disease of the central nervous system in patients with inflammatory bowel disease: retrospective analysis of 9095 patients
Author(s) -
De Felice K. M.,
Novotna M.,
Enders F. T.,
Faubion W. A.,
Tremaine W. J.,
Kantarci O. H.,
Raffals L. E.
Publication year - 2015
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/apt.12997
Subject(s) - medicine , ulcerative colitis , inflammatory bowel disease , crohn's disease , gastroenterology , retrospective cohort study , demyelinating disease , disease , cohort , immunology
Summary Background Anti‐ TNF α biologics induce and maintain remission in inflammatory bowel disease ( IBD ). Also, they have been reported to induce or unmask idiopathic inflammatory demyelinating disease of the central nervous system ( IIDD ). Aim To determine if anti‐ TNF α biologics increased the risk of IIDD in a large cohort of patients with IBD . Methods We retrospectively identified adult patients referred to the Mayo Clinic, Rochester, MN for management of IBD from a five state capture area (Minnesota, Wisconsin, North Dakota, South Dakota and Iowa) between 1996 and 2010. IIDD s were identified in both Crohn's disease ( CD ) and ulcerative colitis ( UC ) patients with and without anti‐ TNF α exposure using the 2010 McDonald MRI criteria. The risk of IIDD s in patients with and without anti‐ TNF α exposure was estimated for IBD ; CD and UC groups separately. Results A total of 9095 patients with IBD were identified (4342 CD and 4753 UC ). Four patients with CD with exposure to anti‐ TNF α agents (4/2054) and five patients with CD without anti‐ TNF α exposure (5/2288) developed a confirmed IIDD . One patient with UC with exposure to anti‐ TNF α agents (1/1371) and five patients with UC without anti‐ TNF α agents developed a confirmed IIDD (5/3382). The per cent of IIDD s in patients with and without anti‐ TNF α exposure was; IBD : 0.15% and 0.18% ( RR = 0.83, 95% CI : 0.28–2.42; P = 0.729); CD : 0.19% and 0.22% ( RR = 0.89, 95% CI : 0.24–3.31; P = 0.863); UC : 0.07% and 0.15% ( RR = 0.49, 95% CI : 0.06–4.22; P = 0.510). Conclusion Anti‐ TNF α biologics do not appear to impact the risk of developing clinical idiopathic inflammatory demyelinating disease in patients with inflammatory bowel disease.