Caldera Freddy, Singh Siddharth, Zona Emily E, Ramirez Oscar Ramirez, Inselman Jonathan, Heien Herbert, Keaveny Andrew P, Hayney Mary S, Farraye Francis A
Department of Medicine, Division of Gastroenterology and Hepatology, School of Medicine & Public Health, University of Wisconsin-Madison, Madison, Wisconsin.
Division of Gastroenterology, Division of Biomedical Informatics, University of California San Diego, La Jolla, California.
Clin Gastroenterol Hepatol. 2025 Feb;23(2):331-340.e2. doi: 10.1016/j.cgh.2024.09.022. Epub 2024 Oct 24.
BACKGROUND & AIMS: Patients with inflammatory bowel disease (IBD) are at an increased risk for vaccine-preventable diseases, such as herpes zoster (HZ). The aim of this study was to determine whether complications of HZ are more frequent in patients with IBD than in non-IBD controls.
This was a retrospective, cohort study using the Optum Research Database. Patients with IBD were matched 1:1 to non-IBD controls based on age, sex, and index year, which was defined as the diagnosis of HZ. We then identified the complications of HZ that occurred up to 90 days after the index date. We compared patients with IBD with non-IBD controls and evaluated the 90-day risk of HZ complications. We used a composite primary outcome for any HZ complication. Secondary outcomes were risk factors for complications.
A total of 4756 patients with IBD met the inclusion criteria and were matched to the controls. Patients with IBD were more likely to have complications of HZ than controls (738 [15.52%] vs 595 [12.51%]; P < .0001). Patients with IBD with higher comorbidity scores were more likely to develop complications (1.86 vs 1.18; P < .0001). In the logistic regression analysis of patients with IBD having a higher comorbidity score, above 50 years of age, on anti-tumor necrosis factor (TNF) or corticosteroids were all at increased risk of a complication of HZ.
Patients with IBD are more likely to have complications of HZ than controls. Efforts are needed to increase HZ vaccine uptake to reduce the morbidity of HZ.
炎症性肠病(IBD)患者罹患疫苗可预防疾病(如带状疱疹,HZ)的风险增加。本研究旨在确定IBD患者发生HZ并发症的频率是否高于非IBD对照者。
这是一项使用Optum研究数据库的回顾性队列研究。根据年龄、性别和索引年份(定义为HZ诊断时间),将IBD患者与非IBD对照者按1:1进行匹配。然后,我们确定索引日期后90天内发生的HZ并发症。我们将IBD患者与非IBD对照者进行比较,并评估HZ并发症的90天风险。我们使用任何HZ并发症的综合主要结局。次要结局是并发症的危险因素。
共有4756例IBD患者符合纳入标准并与对照者匹配。IBD患者发生HZ并发症的可能性高于对照者(738例[15.52%]对595例[12.51%];P <.0001)。合并症评分较高的IBD患者发生并发症的可能性更大(1.86对1.18;P <.0001)。在对合并症评分较高、年龄超过50岁、使用抗肿瘤坏死因子(TNF)或皮质类固醇的IBD患者进行的逻辑回归分析中,发生HZ并发症的风险均增加。
IBD患者发生HZ并发症的可能性高于对照者。需要努力提高HZ疫苗接种率以降低HZ的发病率。