Rare Side Effects of Medications for Crohn’s Disease and Ulcerative Colitis

Medications often play an important role in the lives of people with Crohn’s disease or ulcerative colitis. An important part of the discussion that doctors have with patients, is discussing the risks (i.e. side effects) associated with the medications being considered.

One of the most effective ways to understand risks of medications is by comparing them to the risks of other scenarios in our lives, such as the risk of dying in a motor vehicle accident or the risk of drowning. For example, if we take 10,000 individuals in the general population and follow them for a year, 118 are likely to die in a motor vehicle accident. Of that same group of individuals, 2 are likely to die from non-Hodgkin lymphoma.

Here are some rates of risk for people with Crohn’s disease or ulcerative colitis to consider:

  • Dying in a car accident: 118/10,000
  • Malignancy (cancer) when on Crohn’s or colitis medications such as steroids, IM or narcotics, but not on an anti-TNF: 56/10,000
  • Malignancy (cancer) when on an anti-TNF: 44/10,000
  • Dying from a colectomy: 230/10,000

Note these abbreviations:
Anti-TNF = Cimzia, Remicade, Humira, etc.
IM = azathioprine, methotrexate, etc.;

For more common side effects, check out this article about common side effects of medications for Crohn's and colitis.

Pictograms to help put risks into perspective

Each pictogram below has 10,000 dots representing 10,000 people. They show the rates of side effects for non-Hodgkins lymphoma, serious infection, tuberculosis, and overall malignancy among patients not receiving biologic therapy or patients receiving biologic therapy, as represented in cases per 10,000 people. As a comparison, the last pictograms show the risk of morbidity and mortality associated with colectomy, and the general risk of death from car accidences or drowning.

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There are also some more common side effects you should know about. You can read about them here:
Common Side Effects of Medications for Crohn’s Disease and Ulcerative Colitis

Source: Siegel, C. A. Review article: explaining risk of inflammatory bowel disease therapy to patients. Aliment Pharmacol Ther 2011; 33: 23-32

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