Early-life mebendazole exposure ups risk of adult-onset ulcerative colitis

Early-life exposure to mebendazole, a broad-spectrum anthelminthic agent, tends to increase the risk of adult-onset ulcerative colitis (UC), a study has found.

In this population-based cohort study, the authors used prospectively collected historical data of all individuals born in Denmark between 1995 and 2018. They identified mebendazole exposure at age <18 years and during early life (younger than 5 years).

Adjusted Cox proportional hazards regression analysis was then performed to assess the risk of inflammatory bowel disease (IBD), UC, and Crohn’s disease (CD) with mebendazole exposure after adjusting for potential confounders.

A total of 1,520,290 individuals were identified, of whom 615,794 had childhood or adolescence mebendazole exposure. Subsequently, 1,555 and 1,499 individuals were diagnosed with paediatric- and adult-onset IBD, respectively.

Multivariable analysis revealed at exposure to mebendazole at <18 years of age was not significantly associated with paediatric- or adult-onset IBD (adjusted hazard ratio [aHR], 0.97, 95 percent confidence interval [CI], 0.87‒1.07 and aHR, 1.08, 95 percent CI, 0.97‒1.19, respectively).

When limiting mebendazole exposure to early-life years (<5 years of age), no association was observed with paediatric-onset IBD (aHR, 0.98, 95 percent CI, 0.87‒1.11), but the risk of adult-onset IBD was significantly elevated (aHR, 1.17, 95 percent CI, 1.04‒1.31). Such risk increase was driven by UC (aHR, 1.32, 95 percent CI, 1.12‒1.55), but not CD (aHR, 1.03, 95 percent CI, 0.87‒1.22).

“These findings suggest the importance of early-life exposures in shaping the risk of IBD later in life,” the authors said.