Inflammatory bowel disease carries increased meningitis hazard

Patients with inflammatory bowel disease (IBD) are at heightened risk of meningitis, although the number of those who develop the condition is low, a study has found.

Researchers conducted a retrospective cohort and nested case-control study using data from the Quintiles IMS Legacy PharMetrics Adjudicated Claims Database. The analysis included 50,029 patients with Crohn’s disease (CD), 59,830 patients with ulcerative colitis (UC), and 296,801 matched non-IBD comparators. The matching was based on age, sex, and region.

In the cohort, meningitis was identified in 85 CD patients, 77 UC patients, and 235 comparators. The number of those who had meningitis was 2.17 times higher in the CD group and 1.63 times higher in the UC group than in the non-IBD group. Meningitis was defined as a condition associated with an emergency department visit or hospitalization.

Conditional logistic regression models adjusted for relevant covariates showed that having at least one comorbidity conferred significantly higher odds of a meningitis claim (odds ratio [OR], 2.21, 95 percent confidence interval [CI], 1.76–2.77).

Conversely, treatment with mesalamine appeared to be protective (OR, 0.40, 95 percent CI, 0.26–0.62).

In light of the present data, the researchers recommend that physicians discuss with their patients the increase in the risk of meningitis in IBD, as well as the potential of receiving pneumococcal and meningococcal vaccinations.