IBD causes increased risk of death from circulatory and respiratory disease

...Leavey points out that there are a variety of treatments for each condition: Several anti-inflammatory and disease-modifying drugs are used for rheumatoid arthritis, a variety of medications and diets are used for ulcerative colitis, and antibiotics and lung treatments are used for pneumonia.

Eric Matteson, MD, a rheumatologist at the Mayo Clinic in Rochester, Minnesota, tells Yahoo Health that Frey’s death highlights the severity of rheumatoid arthritis and ulcerative colitis.

“The life expectancy of people who have rheumatoid arthritis that is very severe can be diminished, especially if there are complications of the disease outside the joints,” he says. “People with rheumatoid arthritis have a twofold risk of infection.”

Immune-suppressant medication is typically used for ulcerative colitis, which also increases a person’s risk of infection. “People who battle rheumatoid arthritis and ulcerative colitis, and for as long as Glenn Frey did, are incredibly courageous,” Matteson says.

While many people recover from pneumonia, Leavey calls the infection “opportunistic” and says it will often occur in people who are suffering form another disease.

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Abstract

Background & Aims: Safety issues are a major concern for patients considering treatments for inflammatory bowel disease (IBD). We performed a systematic review and meta-analysis to determine whether biologic agents affect the risk of infection or malignancy in adults with IBD.

Methods: We searched PubMed, Embase, Scopus, Cochrane IBD Group Specialized Trials Register, World Health Organization International Clinical Trials Registry Platform, and ClinicalTrials.gov through March 2016 for randomized placebo-controlled or head-to-head trials of biologic agents approved for treatment of adults with IBD (ie, adalimumab, certolizumab, golimumab, infliximab, natalizumab, or vedolizumab). Two reviewers independently extracted study data and outcomes (serious infections, opportunistic infections, tuberculosis, any infection, and malignancies) and rated each trial's risk of bias. We used conventional meta-analysis to synthesize direct evidence and a network meta-analysis for adjusted indirect treatment comparisons.


Results: We identified 49 randomized placebo-controlled studies comprising 14,590 participants. Synthesis of the evidence indicated that patients treated with biologics had a moderate increase in risk of any infection (odds ratio [OR], 1.19; 95% confidence interval [CI], 1.10–1.29) and a significant increase in risk of opportunistic infections (OR, 1.90; 95% CI, 1.21–3.01). Risk of serious infections was not increased in patients treated with biologics (OR, 0.89; 95% CI, 0.71–1.12). On the contrary, biologics appeared to significantly reduce risk of serious infections in studies with low risk of bias (OR, 0.56; 95% CI, 0.35–0.90). We did not find an increased risk of malignancy with use of biologic agents (OR, 0.90; 95% CI, 0.54–1.50), but data were insufficient in terms of exposure and follow-up times. None of the indirect comparisons, either among the individual agents or between the anti–tumor necrosis factor and anti-integrin classes, reached significance for any of the outcomes analyzed.

Conclusions: On the basis of a systematic review and meta-analysis, biologic agents increase the risk of opportunistic infections in patients with IBD, but not the risk of serious infections. It is necessary to continue to monitor the comparative and long-term safety profiles of these drugs.

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