IBD patients at higher risk for meningitis

The overall rate of meningitis is low among patients with inflammatory bowel disease (IBD), but they remain at increased risk than their non-IBD counterparts, according to a study.

“Comorbidities are a risk factor for meningitis in IBD patients,” the investigators said. “Pneumococcal and meningococcal vaccinations should be discussed.”

A retrospective cohort and nested case-control study was performed using the Quintiles IMS Legacy PharMetrics Adjudicated Claims Database from January 2001 to June 2016. IBD patients were matched to those without IBD on age, sex, enrolment, and region.

Meningitis was defined as one code for meningitis associated with an emergency department visit or hospitalization. The investigators calculated the risk of meningitis with incidence rate ratios and determined its predictors using multivariable conditional logistic regression models.

A total of 50,029 patients with Crohn’s disease (CD) and 59,830 with ulcerative colitis (UC) were identified and matched to a total of 296,801 non-IBD comparators. Meningitis occurred in 85 CD patients, 77 UC patients, and 235 comparators. CD and UC patients had 2.17 and 1.63 times the rate of meningitis, respectively, as non-IBD comparators.

After adjusting for relevant covariates among those with IBD, treatment with mesalamine resulted in a significantly reduced likelihood of a meningitis claim (odds ratio [OR], 0.40, 95 percent confidence interval [CI], 0.26–0.62).

In addition, having at least one comorbidity correlated with a significantly increased likelihood of a meningitis claim (OR, 2.21, 95 percent CI, 1.76–2.77).