Crohn disease, comorbidities up risk for severe pneumococcal disease

For veterans with inflammatory bowel disease (IBD), the risk for severe pneumococcal disease (SPD) is increased with Crohn disease and with more comorbidities, and pneumococcal vaccination is associated with a reduced risk for SPD, according to a study published online Jan. 25 in the Journal of Crohn's and Colitis.

Bryan L. Love, Pharm.D., M.P.H., from the University of South Carolina in Columbia, and colleagues examined the prevalence of SPD and evaluated the impact of pneumococcal vaccination on the risk for SPD in veterans with IBD. A total of 1,798 SPD cases were identified from the VA Health Administration database.

The researchers found that patients with SPD were older (60.9 versus 59.4 years), had more comorbidities (Charlson Comorbidity Index, 2.11 versus 0.96), and had elevated mortality (4.6 versus 1.5 percent). Elevated SPD risk was seen with Crohn disease and with more comorbidities (hazard ratios, 1.15 and 1.45, respectively). The risk for SPD was increased with the use of immunosuppressive medications. Compared with no vaccination, receipt of PCV13 alone or in combination with PPSV23 predicted a fivefold reduced risk for SPD.

"The impact of vaccination on severe pneumococcal disease demonstrated in the current study further supports the professional gastrointestinal society recommendations for pneumococcal vaccination in all IBD patients, particularly those receiving or expected to receive chronic immunosuppressive therapies," the authors write.

One author disclosed financial ties to the biopharmaceutical industry.

More information: Abstract/Full Text

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