医学
内科学
抗生素
炎症性肠病
溃疡性结肠炎
炎症性肠病
疾病
生物
微生物学
作者
Yuri Gorelik,Itai Ghersin,Deema Shlon,C Friss,R Lujan,Yiska Loewenberg Weisband,Shira Greenfeld,Revital Kariv,Natan Ledderman,Eran Matz,Iris Dotan,Haggai Bar‐Yoseph,Yehuda Chowers,Dan Turner
出处
期刊:Journal of Crohn's and Colitis
[Oxford University Press]
日期:2023-04-21
卷期号:17 (9): 1410-1417
被引量:1
标识
DOI:10.1093/ecco-jcc/jjad070
摘要
Different antibiotic classes were reported to have variable effects on immunogenicity towards anti-tumour necrosis factor [TNF] agents. However, the impact of antibiotic administration on biologic treatment durability was not investigated. We aimed to assess the association between antibiotic treatment and persistence of different classes of biologic therapy in inflammatory bowel disease [IBD] patients.Data from the epi-IIRN, a nationwide registry of all Israeli IBD patients were analysed. All patients who filled a prescription of either infliximab, adalimumab, vedolizumab, or ustekinumab, were included. Treatment cessation was defined as drug discontinuation of at least 6 months. Macrolides, cephalosporins, fluoroquinolones, and penicillins with beta-lactamase inhibitors were selected as primary exposure variables. Survival analysis was performed using marginal structural models for each drug separately.In all 13 513 IBD patients, with a total of 39 600 patient-years, were included. Significant differences of overall treatment persistence were demonstrated, with highest persistence rates for ustekinumab and the lowest for infliximab treatment. Macrolides were found to be significantly associated with reduced risk of infliximab cessation (adjusted hazard ratio [aHR] 0.72, 95% CI 0.62-0.89]. Fluoroquinolones and cephalosporins were associated with an elevated risk of adalimumab treatment cessation [aHR 1.33, 95% CI 1.22-1.46; and aHR 1.20, 95% CI 1.08-1.34, respectively]. No significant effects of the studied antibiotics were observed in ustekinumab and vedolizumab users.Specific antibiotic classes are associated with duration of anti-TNF treatment, but not with durability of vedolizumab or ustekinumab treatments. Further research is required to study the effect of specific antibiotics on response to biologics.
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