TNF inhibitors increased the risk of immune-mediated inflammatory diseases
The use of tumor necrosis factor inhibitors in the treatment of inflammatory bowel disease increases the likelihood of developing other immune-mediated inflammatory diseases. Compared to azathioprine monotherapy, the risk was increased almost threefold.Researchers from Aalborg University, Zealand University Hospital in Denmark, the State Serum Institute in Copenhagen and Sorbonne University found that tumor necrosis factor (TNF) inhibitors, which are prescribed to treat inflammatory bowel disease, increase the risk of developing immune-mediated inflammatory diseases, including rheumatoid arthritis, psoriasis and suppurative hidradenitis. The findings are published in the journal Clinical Gastroenterology and Hepatology.
They analyzed data from the Danish Public Health Register and the French National Health Insurance database from 2005 to 2018. The study included data from 18,000 patients with inflammatory bowel disease from Denmark and 88,700 people with the same diagnosis from France. Half of the participants were receiving TNF inhibitors. The mean age of the Danes was 38 years and the French patients 36 years.
An analysis taking into account gender, subtype of inflammatory bowel disease, severity of its course, therapy received and comorbidities showed that taking TNF inhibitors increased the overall risk of developing immune-mediated inflammatory diseases by 76%. Participants from France were 78% more likely to develop the diseases, and patients from Denmark were 66% more likely to develop the diseases. The risk of rheumatoid arthritis was increased by 47%, psoriasis by 83%, and purulent hidradenitis by 2.12-fold.
Compared to azathioprine monotherapy, the risk of immune-mediated inflammatory diseases was almost 3-fold increased with TNF inhibitors (risk ratio was 2.94).
The researchers noted that they lacked data on smoking status, which may influence the risk of psoriasis in people with inflammatory bowel disease.