Antibiotics, hormonal medications, oral contraceptives, and long-term NSAID use associated with increased odds of incident IBD after adjustment for covariates suggests a recent study published in the Clinical Gastroenterology and Hepatology
Several medications have been suspected to contribute to the etiology of inflammatory bowel disease (IBD). This study assessed the association between medication use and risk of developing IBD using the Prospective Urban Rural Epidemiology (PURE) cohort.


This was a prospective cohort study of 133,137 individuals between the ages of 20-80 from 24 countries. Country-specific validated questionnaires documented baseline and follow-up medication use. Participants were followed prospectively at least every 3 years. The main outcome was development of IBD, including Crohn's disease (CD) and ulcerative colitis (UC). Short-term (baseline but not follow-up use) and long-term use (baseline and subsequent follow-up use) were evaluated. Results are presented as adjusted odds ratios (aOR) with 95% confidence intervals (CI).

Results:
During a median follow-up of 11.0 years, there were 571 incident IBD cases
Incident IBD was significantly associated with baseline antibiotic and hormonal medication use
Among females, previous or current oral contraceptive use was also associated with IBD development [aOR: 2.17 (95% CI: 1.70-2.77), p<0.001]. NSAID users were also observed to have increased odds of IBD [aOR: 1.80 (95% CI: 1.23-2.64), p=0.002], which was driven by long-term use [aOR: 5.58 (95% CI: 2.26-13.80), p<0.001]. All significant results were consistent in direction for CD and UC with low heterogeneity.

Antibiotics, hormonal medications, oral contraceptives, and long-term NSAID use were associated with increased odds of incident IBD after adjustment for covariates.


Reference:
Neeraj Narula, Emily C.L. Wong, Cara Pray, John K. Marshall, Sumathy Rangarajan, Shofiqul Islam, Ahmad Bahonar, Khalid F. Alhabib, Anna Kontsevaya, Farnaza Ariffin, Homer U. Co, Wadeia Al Sharief, Andrzej Szuba, Andreas Wielgosz, Maria Luz Diaz, Rita Yusuf, Lanthé Kruger, Biju Soman, Yang Li, Chuangshi Wang, Lu Yin, Mirrakhimov Erkin, Fernando Lanas, Kairat Davletov, Annika Rosengren, Patricio Lopez-Jaramillo, Rasha Khatib, Aytekin Oguz, Romaina Iqbal, Karen Yeates, Álvaro Avezum, Walter Reinisch, Paul Moayyedi, Salim Yusuf. Associations of Antibiotics, Hormonal Therapies, Oral Contraceptives, and Long-Term NSAIDs with Inflammatory Bowel Disease: Results from the Prospective Urban Rural Epidemiology (PURE) Study, Clinical Gastroenterology and Hepatology,
2022, ISSN 1542-3565, https://doi.org/10.1016/j.cgh.2022.11.037.

Keywords:
Neeraj Narula, Emily C.L. Wong, Cara Pray, John K. Marshall, Sumathy Rangarajan, Shofiqul Islam, Ahmad Bahonar, Khalid F. Alhabib, Anna Kontsevaya, Farnaza Ariffin, Homer U. Co, Wadeia Al Sharief, Andrzej Szuba, Andreas Wielgosz, Maria Luz Diaz, Rita Yusuf, Lanthé Kruger, Biju Soman, Yang Li, Chuangshi Wang, Lu Yin, Mirrakhimov Erkin, Fernando Lanas, Kairat Davletov, Annika Rosengren, Patricio Lopez-Jaramillo, Rasha Khatib, Aytekin Oguz, Romaina Iqbal, Karen Yeates, Álvaro Avezum, Walter Reinisch, Paul Moayyedi, Salim Yusuf, Associations, Antibiotics, Hormonal Therapies, Oral Contraceptives, and Long-Term NSAIDs, Inflammatory, Bowel Disease, Clinical Gastroenterology and Hepatology,