From the Department of Gastroenterology and Hepatology, Elisabeth-Tweesteden Hospital, Tilburg, the Netherlands.
Inflamm Bowel Dis. 2024 Sep 3;30(9):1510-1516. doi: 10.1093/ibd/izad216.
Patients with inflammatory bowel disease (IBD) treated with immunomodulators or biologic therapy are at increased risk of infections. Malnutrition and vitamin or mineral deficiencies are common among patients with IBD. The results of various studies have indicate that vitamin deficiencies might increase the risk of infections. To evaluate the efficacy of a multivitamin and mineral supplement on the incidence of infections in patients with IBD treated with immunomodulators, biologic therapy, or combination therapy.
This was a single-center, randomized, double-blind, placebo-controlled clinical trial to compare a multivitamin and mineral supplement (supplemented group) vs identical-in-appearance placebo (placebo group) in a total of 320 non-vitamin-deficient patients with IBD (Crohn's disease or ulcerative colitis) in remission with immunomodulators, biologic therapy, or combination therapy. Participants were asked to take a daily multivitamin and mineral supplement or placebo and report the occurrence of infections during a 24-week period of follow-up.
Treatment arms consisted of 162 and 158 patients for the supplement and placebo, respectively. In both treatment groups, 107 patients reported an infection during the 24-week follow-up period (unadjusted odds ratio, 0.93; 95% confidence interval, 0.56-1.48). In the supplemented group, 32 patients received antibiotics for an infection compared with 21 patients in the placebo group (unadjusted odds ratio, 1.61; 95% confidence interval, 0.88-2.93).
An over-the-counter multivitamin and mineral supplement did not reduce the risk of infection for patients with IBD in remission with immunomodulators, biologic therapy, or combination therapy.
接受免疫调节剂或生物治疗的炎症性肠病(IBD)患者感染风险增加。营养不良和维生素或矿物质缺乏在 IBD 患者中很常见。多项研究结果表明,维生素缺乏可能会增加感染的风险。评估多种维生素和矿物质补充剂对接受免疫调节剂、生物治疗或联合治疗的 IBD 患者感染发生率的影响。
这是一项单中心、随机、双盲、安慰剂对照的临床试验,比较了 320 名非维生素缺乏的 IBD(克罗恩病或溃疡性结肠炎)缓解期患者接受免疫调节剂、生物治疗或联合治疗时,使用多种维生素和矿物质补充剂(补充组)与外观相同的安慰剂(安慰剂组)的疗效。要求参与者每天服用多种维生素和矿物质补充剂或安慰剂,并在 24 周的随访期间报告感染的发生情况。
治疗组分别有 162 名和 158 名患者接受补充剂和安慰剂治疗。在两个治疗组中,107 名患者在 24 周的随访期间报告了感染(未调整的优势比,0.93;95%置信区间,0.56-1.48)。在补充组中,32 名患者因感染接受了抗生素治疗,而安慰剂组中则有 21 名患者(未调整的优势比,1.61;95%置信区间,0.88-2.93)。
对于缓解期接受免疫调节剂、生物治疗或联合治疗的 IBD 患者,非处方多种维生素和矿物质补充剂不能降低感染风险。