Counseling on skin protection is insufficient among immune-suppressed patients with inflammatory bowel disease (IBD), according to the results of a study recently presented at the Advances in Inflammatory Bowel Disease Annual Meeting (Dec. 10-12, 2015), held in Orlando.
“Potential adverse effects of immune-suppressing medications require patient education and counseling,” wrote Marie L. Borum, MD, EdD, MPH, division of gastroenterology and liver diseases, George Washington University, Washington, D.C., and colleagues according to a news release. “It is recommended that individuals with IBD who are treated with immunosuppressants be counseled regarding preventative measures to reduce their risk of skin cancer.”
With the aim of understanding the disparities between physician counseling practices regarding the risk of skin cancer, Dr. Borum and colleagues conducted a retrospective study where they collected and analyzed clinical data on 136 chronic IBD patients accompanied at an urban medical center for a period of one year.
Of the patients analyzed, 27.9% (n = 38) were under immunomodulator therapy, and of these, 28 patients were on monotherapy and 10 patients were on combined immunomodulator and biologic therapy. Nearly 12% of the patient cohort was receiving biologic monotherapy (n = 17), and 81 patients were neither under immunomodulator nor biologic therapy.
In total, the results revealed that 32% of the patients under treatment with immunomodulators received skin protection counseling.
“IBD patients are at an increased risk for skin cancers. This risk may be related to the underlying disease, medications or both, (…) This study revealed that [less than] 50% of patients had documented counseling regarding skin protective activities,” concluded the research team. “While this study is limited due to size and single institution design, it suggests that increased efforts should be made to enhance counseling about skin cancer risk to optimize IBD patient care”.
IBD is a condition that involves chronic inflammation of all or part of the digestive tract. IBD primarily includes ulcerative colitis and Crohn’s disease, and both usually involve severe diarrhea, pain, fatigue and weight loss. The condition can be debilitating and sometimes lead to life-threatening complications. In the United States, it is currently estimated that about 1 –1.3 million people suffer from IBD. Immunosuppression is a reduction of the activation or efficacy of the immune system, an important therapy used in cases of autoimmune diseases, such as IBD, where the immune system is exacerbated and has an abnormal response. Immunosupressive drugs can, however, have side effects as the individual becomes more prone to infections and cancer development.