Associations of antibiotics, hormonal therapies, oral contraceptives, and long-term NSAIDs with inflammatory bowel disease: Results from the Prospective Urban Rural Epidemiology (PURE) study

Neeraj Narula, Department of Medicine (Division of Gastroenterology) and Farncombe Family Digestive Health Research Institute; McMaster University, Hamilton ON, Canada; Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada. Electronic address: Neeraj.narula@medportal.ca.
Emily C. Wong, Department of Medicine (Division of Gastroenterology) and Farncombe Family Digestive Health Research Institute; McMaster University, Hamilton ON, Canada.
Cara Pray, Department of Medicine (Division of Gastroenterology) and Farncombe Family Digestive Health Research Institute; McMaster University, Hamilton ON, Canada.
John K. Marshall, Department of Medicine (Division of Gastroenterology) and Farncombe Family Digestive Health Research Institute; McMaster University, Hamilton ON, Canada.
Sumathy Rangarajan, Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada.
Shofiqul Islam, Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada.
Ahmad Bahonar, Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.Follow
Khalid F. Alhabib, Department of Cardiac Sciences, King Fahad Cardiac Center, College of Medicine, King Saud Medical City, King Saud University.Follow
Anna Kontsevaya, National research center for therapy and preventive medicine, 101000 Russian Federation, Moscow, Petroverigski ms, 10.
Farnaza Ariffin, Primary Care Medicine, Faculty of Medicine UiTM, Sungai Buloh Campus, 47000 Sungai Buloh, Selangor, Malaysia.
Homer U. Co, University of the Philippines College of Medicine.Follow
Wadeia Al Sharief, Family Medicine Department, Medical Education & Research Department in Dubai Health Authority (DHA).
Andrzej Szuba, Wroclaw Medical University, Department of Angiology, Hypertension and Diabetology Borowska 213 street; 50- 556 Wroclaw, Poland.
Andreas Wielgosz, University of Ottawa Heart Institute 40 Ruskin St, Ottawa ON.
Maria Luz Diaz, ECLA Rosario, Santa Fe, Argentina.
Rita Yusuf, Independent University, Bangladesh Plot 16, Block B, Aftabuddin Ahmed Road, Bashundhara R/A, Dhaka, Bangladesh.
Lanthé Kruger, Africa Unit for Transdisciplinary Health Research (AUTHeR).
Biju Soman, Member, Health Action by People(HAP), Thiruvananthapuram, Kerala, India. Professor, AMCHSS, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India.
Yang Li, Medical Research & Biometrics Center, National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College & Chinese Academy of Medical Sciences.
Chuangshi Wang, Medical Research & Biometrics Center, National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College & Chinese Academy of Medical Sciences.
Lu Yin, Medical Research & Biometrics Center, National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College & Chinese Academy of Medical Sciences.
Mirrakhimov Erkin, Kyrgyz State Medical Academy, 92, Akhunbaev street, 720020, Bishkek, Kyrgyzstan.
Fernando Lanas, Universidad de La Frontera, M Montt 112, Temuco, Chile.
Kairat Davletov, Al-Farabi Kazakh National University, Health Research Institute, 71 Al-Farabi Avenu, Almaty, Kazakhstan.Follow
Annika Rosengren, Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital, VGR region, Sweden.
Patricio Lopez-Jaramillo, Masira Research Institute, Medical School, Universidad de Santander (UDES), Bucaramanga, Colombia.
Rasha Khatib, Advocate Aurora Research Institute, Advocate Aurora Health, Downers Grove, IL; Institute of Community and Public Health, Birzeit University, Birzeit, Palestine.Follow
Aytekin Oguz, Istanbul Medeniyet University, Faculty of Medicine, Department of Internal Medicine, Istanbul, Turkey.
Romaina Iqbal, Department of Community Health Sciences, Aga Khan University.
Karen Yeates, Department of Medicine, Queen's University 94 Stuart Street, Etherington Hall, Kingston, Ontario.
et al

Affiliations

Advocate Aurora Research Institute

Abstract

Background: 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.

Methods: 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 [interquartile range (IQR) 9.2-12.2], there were 571 incident IBD cases (143 CD and 428 UC). Incident IBD was significantly associated with baseline antibiotic [aOR: 2.81 (95% CI: 1.67-4.73), p=0.0001] and hormonal medication use [aOR: 4.43 (95% CI: 1.78-11.01), p=0.001]. Among females, previous or current oral contraceptive use was also associated with IBD development [aOR: 2.17 (95% CI: 1.70-2.77), p

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

Document Type

Article

PubMed ID

36528284

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