β-Blocker use is associated with a higher relapse risk of inflammatory bowel disease: a Dutch retrospective case-control study

Rose A Willemze, Tinka Bakker, Maria Pippias, Cyriel Y Ponsioen, Wouter J de Jonge

Research output: Contribution to journalArticle (Academic Journal)peer-review

Abstract

OBJECTIVE: Inflammatory bowel disease (IBD) is a multifactorial disease and many factors may influence the disease course, like the concomitant use of medication. An example thereof is the use of β-blockers, antagonizing β-adrenergic receptors. β-adrenergic receptor activation has potent anti-inflammatory effects on the immune system. We addressed whether an association exists between the use of beta-blockers and the course of IBD, defined by the risk of a disease relapse in patients with IBD.

PATIENTS AND METHODS: In this retrospective case-control study, we used a population-based cohort of patients with IBD. We identified colitis relapses using IBD medication prescriptions as a proxy. We calculated the number of relapses per 100 person-years and compared this between patients with IBD using β-blockers and patients with IBD not using β-blockers. We used Cox proportional hazards models with shared frailty to compare the relative relapse risk between both groups.

RESULTS: A total of 250 patients with IBD were included, of which 30 patients used a β-blocker for at least 3 months. With the Cox proportional hazards model with shared frailty, adjusted for age and sex, we observed a 54% (hazard ratio: 1.54; 95% confidence interval: 1.05-2.25; P=0.03) higher risk of a relapse in the group of patients with IBD using β-blockers versus the group not using β-blockers.

CONCLUSION: Even in this limited cohort study, we show that patients with IBD using β-blockers have an increased relapse risk. Indeed, concomitant medication use seems to be a factor that can influence the course of IBD, and this should be acknowledged while making decisions about treatment of IBD and follow-up.

Original languageEnglish
Pages (from-to)161-166
Number of pages6
JournalEuropean Journal of Gastroenterology and Hepatology
Volume30
Issue number2
DOIs
Publication statusPublished - 1 Feb 2018

Keywords

  • Adrenergic beta-Antagonists/therapeutic use
  • Adult
  • Aged
  • Case-Control Studies
  • Colitis, Ulcerative/epidemiology
  • Crohn Disease/epidemiology
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Netherlands
  • Proportional Hazards Models
  • Recurrence
  • Retrospective Studies
  • Risk Factors

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