P3622 - Use of Immunomodulators or Biologics and Risk of Pneumonia Among IBD Patients

Maxwell Barffour, PhD¹, Mustafa Gandhi, MD², Emily Reznicek, MD³, Harleen Chela, MD¹, Kwame Frimpong, BSc⁴, Kevin Luton, BSc¹, Elizabeth Karanja, BSc¹, Emily Bosak, MD⁵, Matthew Bechtold, MD¹, Yezaz Ghouri, MD^6
1University of Missouri School of Medicine, Columbia, MO; ²University of Missouri-Columbia, Columbia, MO; ³University of Missouri School of Medicine, Columbia, MO; ⁴University of Missouri School of Medicine, Columbia, MO; ⁵University of Missouri School of Medicine, Columbia, MO; ⁶University of Missouri School of Medicine, Columbia, MO

Introduction: Inflammatory bowel disease (IBD) is an immunologic condition that is primarily treated with immunosuppressive therapy. Elevated infectious disease risk, including pneumonia, is an unintended consequence of immunosuppressive therapy. The goal of our study was to assess the risk of developing pneumonia in patients with IBD while on therapy with immunomodulators and/or biologic agents.

Methods: Data for this study was extracted from electronic health records of IBD patients seen at the University of Missouri Health System between January 2017 to April 2021. Primary outcome was pneumonia defined as a reported diagnosis of pneumonia during the period of observation. Primary exposure variables were use of immunomodulators and biologic agents. We used multivariate logistic regression models to estimate the odds of pneumonia as a function of therapeutic agent used, and controlling for age, race, gender, and use of antibiotics, corticosteroids, PPI and histamine-2 receptor antagonists during the period of observation.

Results: The study included 606 patients diagnosed with IBD, age 17 to 94 years. Overall prevalence of pneumonia was 3.6%. About 32% and 52% of the patient used immunomodulators and biologics respectively, during the period of observation. Use of immunomodulators was associated with an elevated risk of pneumonia (table 1). After controlling for confounders, immunomodulator use was associated with more than 4-fold increase in risk of developing pneumonia (OR=4.45 [1.56-12.65], p=0.005). This increased risk was more pronounced with advancing age (p < 0.01) (figure 1). Use of biologics was not associated with a statistically significant increased risk of developing pneumonia (OR=0.37 [0.12-1.08], p=0.069).

Discussion: In IBD patients, use of immunomodulators, but not biologics was independently associated with increased incidence of pneumonia. This effect was more pronounced in the elderly. More evidence needed to quantify the risk of immunosuppressive therapy-associated pneumonia in vulnerable groups, particularly the elderly.



Disclosures:


Maxwell Barffour, PhD¹, Mustafa Gandhi, MD², Emily Reznicek, MD³, Harleen Chela, MD¹, Kwame Frimpong, BSc⁴, Kevin Luton, BSc¹, Elizabeth Karanja, BSc¹, Emily Bosak, MD⁵, Matthew Bechtold, MD¹, Yezaz Ghouri, MD⁶. P3622 - Use of Immunomodulators or Biologics and Risk of Pneumonia Among IBD Patients, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.