ECCO Guidelines on the Prevention, Diagnosis, and Management of Infections in Inflammatory Bowel Disease

Résumé fourni par la source

The therapeutic landscape of inflammatory bowel disease [IBD] has undergone a profound transformation with the advent of novel immunosuppressive and biologic agents. These advancements have revolutionized the management of Crohn’s disease [CD] and ulcerative colitis [UC], enabling tighter control of inflammation and significantly improved patient outcomes. However, while older treatment strategies, including prolonged corticosteroids, purine analogs, and anti-tumor necrosis factor [TNF]/thiopurine combination therapy, carried a substantial immunosuppressive burden, the expanding therapeutic armamentarium introduces new agents with distinct infection risk profiles that require updated, evidence-based guidance. By definition, opportunistic infections are infections caused by organisms that infrequently induce disease in immunocompetent hosts but can result in significant morbidity or mortality in immunocompromised individuals. As treatment strategies increasingly rely on potent modulation of the immune system, ranging from traditional thiopurines to advanced small molecules, a structured, evidence-based approach to infection prevention, diagnosis, and management has become indispensable for the clinician. The European Crohn’s and Colitis Organisation [ECCO] has long recognized this clinical imperative, previously publishing consensus statements in 2009 and 2014, followed by a comprehensive guideline in 2021. This 2026 update is warranted by the rapid expansion of the therapeutic armamentarium, specifically the introduction of newer small molecules, advanced biologics, and evolving vaccination strategies. This update integrates the most recent data on risk stratification, viral, bacterial, mycobacterial, and vaccine-preventable infections, emphasizing a preventative strategy tailored to the contemporary IBD treatment paradigm.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.