Frequent exposure to biologics is associated with small intestinal bacterial overgrowth in patients with Crohn's disease: a retrospective case-control study.

Quick Summary

This study examined whether biologic medications used to treat Crohn's disease affect the risk of developing SIBO (small intestinal bacterial overgrowth). Researchers found that Crohn's patients who received biologics five or more times had over four times higher odds of testing positive for SIBO compared to those never exposed to biologics.

What Was Studied

Researchers conducted a retrospective case-control study to investigate the relationship between biologic therapy exposure and SIBO development in Crohn's disease patients. The study enrolled 86 Crohn's disease patients (43 with SIBO, 43 without) who underwent breath testing at Jinling Hospital between 2021 and 2024.

How the Study Was Conducted

Researchers at Jinling Hospital reviewed medical records of Crohn's disease patients who had completed lactulose hydrogen-methane breath tests (a diagnostic test that measures gases produced by intestinal bacteria). They compared clinical characteristics between SIBO-positive and SIBO-negative groups and used statistical modeling to identify risk factors, validating their predictive model through multiple analytical methods. Full methodology not publicly available — summary based on abstract only.

Key Findings

• Crohn's patients who received biologics five or more times had 4.5 times higher odds of having SIBO compared to those with no biologic exposure
• Intestinal stenosis (narrowing of the intestines) was also a significant risk factor, with 3.3 times higher odds of SIBO
• A predictive model combining biologic exposure frequency (≥5 times), BMI, steroid use, disease duration, and intestinal stenosis achieved 70.9% accuracy in identifying which Crohn's patients would have SIBO
• Among the 86 patients studied, biologic medication use differed significantly between those who tested positive for SIBO (43 patients) and those who tested negative (43 patients)