Balancing Benefit vs Risk of Immunosuppressive Therapy for Individual Patients With Inflammatory Bowel Diseases

Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association
Laurent Beaugerie, Julien Kirchgesner

Abstract

Inflammatory bowel diseases (IBD) and their treatments, particularly immunosuppressive drugs, increase risk of infections and cancers. However, by promoting mucosal healing, these agents should reduce risks of infections related to intestinal lesions, malnutrition, intravenous devices, and IBD surgeries and reduce risk of cancers associated with chronic mucosal inflammation-although there are few data to support this concept. Corticosteroids increase the risk of vascular thromboembolic events, yet other immunosuppressive drugs that induce deep remission from IBD could decrease the incidence of cardiovascular events attributable to systemic inflammation and IBD-related hospitalizations and/or surgeries. The nature and magnitude of the risks of infections and cancers vary with immunosuppressive drug class and patient sex and age. For example, thiopurines increase risk of viral infections that might be fatal in young patients, whereas tumor necrosis factor antagonists increase risk of bacterial and intracellular infections that can be fatal in patients of any age, but particularly in older patients. The ability of drugs to prevent IBD-associated colorectal cancer varies with IBD location and duration. Models to assess the benefit:...Continue Reading

References

May 9, 2006·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Gary R LichtensteinWilliam J Sandborn
Dec 13, 2006·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Gauree GuptaJames D Lewis
Dec 7, 2007·Gastroenterology·Susan M HutflessLisa J Herrinton
Feb 26, 2008·Gastroenterology·Murat TorunerLaurence J Egan
Aug 8, 2008·The American Journal of Gastroenterology·Geoffrey C Nguyen, Justina Sam
Oct 2, 2008·Risk Analysis : an Official Publication of the Society for Risk Analysis·F Reed JohnsonBruce E Sands
Dec 6, 2008·Journal of Clinical Virology : the Official Publication of the Pan American Society for Clinical Virology·C SpringfeldP Schnitzler
Oct 19, 2010·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Mario CottoneAmbrogio Orlando
Nov 19, 2010·Alimentary Pharmacology & Therapeutics·C A Siegel
Jun 29, 2011·Gastroenterology·Laurent Peyrin-BirouletUNKNOWN Cesame Study Group
May 16, 2012·Gastroenterology·Millie D LongMichael D Kappelman
Aug 15, 2012·The American Journal of Gastroenterology·Gary R LichtensteinWilliam J Sandborn
Sep 20, 2012·Medical Decision Making : an International Journal of the Society for Medical Decision Making·Mark RobertsUNKNOWN ISPOR-SMDM Modeling Good Research Practices Task Force
Sep 20, 2012·Medical Decision Making : an International Journal of the Society for Medical Decision Making·Uwe SiebertKaren M Kuntz
Oct 2, 2012·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Tine JessJacob Simonsen
Dec 18, 2012·Alimentary Pharmacology & Therapeutics·M D LongM D Kappelman
Mar 22, 2013·American Journal of Epidemiology·Björn PasternakAnders Hviid
Apr 5, 2013·Alimentary Pharmacology & Therapeutics·H YuharaT Mine
May 8, 2013·The American Journal of Gastroenterology·Alexander C Ford, Laurent Peyrin-Biroulet
Jun 25, 2013·Inflammatory Bowel Diseases·Derek H TangEdward P Armstrong
Jul 23, 2013·Inflammatory Bowel Diseases·Parambir S DulaiMarla C Dubinsky
Aug 28, 2013·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Siddharth SinghDarrell S Pardi
Mar 19, 2014·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Ashwin N AnanthakrishnanKatherine P Liao
Jun 1, 2014·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·David S KotlyarGary R Lichtenstein
Jun 19, 2014·JAMA : the Journal of the American Medical Association·Nynne Nyboe AndersenTine Jess
Jul 20, 2014·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Peter D R HigginsJingdong Chao
Aug 15, 2014·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Frank I ScottJames D Lewis
Jan 21, 2015·Journal of Crohn's & Colitis·C J van der WoudeUNKNOWN European Crohn’s and Colitis Organization
Aug 22, 2015·Journal of Crohn's & Colitis·Vito AnneseUNKNOWN ECCO
Sep 10, 2015·Journal of Crohn's & Colitis·Jordi GordilloUNKNOWN ENEIDA Project of the Spanish Working Group in Crohn’s Disease and Ulcerative Colitis (GETECCU)
Sep 17, 2015·Journal of Crohn's & Colitis·Dan GreenbergUNKNOWN Israeli IBD Research Nucleus [IIRN]
Dec 22, 2015·Gastroenterology·Geoffrey C NguyenUNKNOWN Canadian Association of Gastroenterology
Feb 20, 2016·Gut·Jean-Frédéric ColombelBrian G Feagan
Apr 18, 2016·The Journal of Investigative Dermatology·Zenas Z N YiuRichard B Warren

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Citations

May 2, 2020·Gut·Cristina BezzioUNKNOWN Italian Group for the Study of Inflammatory Bowel Disease (IG-IBD)
Mar 12, 2020·Current Drug Metabolism·Fabio Salvatore Macaluso, Iago Rodríguez-Lago
Jun 13, 2020·United European Gastroenterology Journal·Andrew WisniewskiUNKNOWN the Saint-Antoine IBD network
Jul 22, 2020·Digestive Diseases and Sciences·Victoria Gudiño, Azucena Salas
Aug 23, 2020·Journal of Clinical Medicine·Virginia SolitanoSilvio Danese
Sep 10, 2019·Inflammatory Bowel Diseases·Livia BianconeUNKNOWN Italian Group for the Study of Inflammatory Bowel Disease (IG-IBD)
Jan 28, 2019·Probiotics and Antimicrobial Proteins·Maria Pina DoreGiovanni Mario Pes
Oct 22, 2020·Dermatologic Therapy·Timothy Tyler Daugherty, Robert Andrew Swerlick
Nov 18, 2020·British Medical Bulletin·Virginia SolitanoSilvio Danese
Mar 7, 2020·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Chun-Han LoAshwin N Ananthakrishnan
Dec 2, 2019·Cellular and Molecular Gastroenterology and Hepatology·Jonathan SkupskyHamid M Said
Mar 30, 2021·World Journal of Gastroenterology : WJG·Eugeni DomènechAxel U Dignass
Dec 12, 2019·La Presse médicale·Julien Kirchgesner
Sep 3, 2020·Journal of Gastroenterology and Hepatology·Harleen ChelaYezaz A Ghouri
Feb 16, 2020·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Laurent BeaugerieJulien Kirchgesner
Nov 29, 2020·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Robert P HirtenJean-Frederic Colombel
Jun 3, 2021·Microorganisms·Mélanie BourginMoez Rhimi
Aug 11, 2020·GE Portuguese Journal of Gastroenterology·Maria Manuela Estevinho, Fernando Magro

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