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* = Presenting author

P716 Beta-blocker use is associated with a higher relapse risk of inflammatory bowel disease – a Dutch retrospective cohort study

Willemze R.*1, Bakker T.1, Pippias M.2, Ponsioen C.3, de Jonge W.1

1Academic Medical Center (AMC), Tytgat Institute for Liver and Intestinal Research, Amsterdam, Netherlands 2Academic Medical Center (AMC), Department of Medical Informatics, Amsterdam, Netherlands 3Academic Medical Center (AMC), Department of Gastroenterology and Hepatology, Amsterdam, Netherlands

Background

Inflammatory bowel disease (IBD) is a multifactorial disease and as such, many factors may influence the disease course – like the concomitant use of medication. One such drug group is beta-blockers, a medication group primarily prescribed for the treatment of cardiovascular disease, which is used by approximately 10% of the Dutch population. Beta-blockers block the β-adrenergic receptors. β-adrenergic receptor activation has potent anti-inflammatory effects on the myeloid compartment of the immune system.

In this pilot study, we addressed whether an association exists between the use of beta-blockers and the course of IBD, as defined by the risk of a disease relapse in patients with IBD.

Methods

In this retrospective cohort study design, we used a population-based IBD cohort of 1461 patients. We identified relapses using medication prescriptions as a proxy. We calculated the number of relapses per 100 person-years and compared this between IBD patients using beta-blockers and IBD patients not using beta-blockers. We used Cox proportional hazards models with shared frailty to compare the risk of a relapse between both groups.

Results

250 IBD patients had available prescriptions and were included in the study, 30 patients (12%) used a beta-blocker. In the beta-blocker group, there were 21 relapses per 100 person-years (95% confidence interval (CI): 14.0–28.6) versus 29 relapses per 100 person-years (95% CI: 26.2–32.4) in the group of patients that did not use a beta-blocker. However, when we used the Cox proportional hazard model with shared frailty and adjusted for age and gender we observed a 54% higher risk of a relapse in the group of IBD patients that used a beta-blocker versus the IBD patients that did not use a beta-blocker (adjusted hazard ratio: 1.54, 95% CI: 1.05–2.25; p=0.03).

Conclusion

The results of our study suggest that beta-blocker use is associated with an increased risk of disease relapses in patients with IBD. Indeed, concomitant medication use seems to be one of the factors that can influence the course of IBD and this should be acknowledged while making decisions about treatment of IBD and follow-up. These results warrant confirmation in a larger cohort.