ArticleJournal of thoracic disease2026
Inflammatory bowel disease and risk of non-tuberculous mycobacterial pulmonary disease: a nationwide retrospective cohort study in Korea.
Article in Journal of thoracic disease, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Inflammatory bowel disease (IBD) is a chronic immune-mediated disorder of the gastrointestinal tract, and patients with IBD are vulnerable to infections. Non-tuberculous mycobacterial pulmonary disease (NTM-PD) is an infection of concern in immunocompromised individuals. However, data on the risk of NTM-PD in IBD patients are limited. This study aimed to investigate the association between IBD and the risk of NTM-PD using nationwide data in Korea. Methods: We conducted a population-based matched cohort study involving 6,869 adults aged ≥20 years with IBD, using data acquired from the Korean National Health Insurance Service-National Sample Cohort (NHIS-NSC) database between 2002 and 2019. Multivariable Cox proportional hazards regression analyses were performed to estimate the hazard ratio (HR) and corresponding 95% confidence interval (CI) for incident NTM-PD in the overall IBD and IBD subtype cohorts (Crohn's disease and ulcerative colitis) compared to their respective 1:4 age-, sex-, and health insurance-matched cohorts. Fine-Gray subdistribution hazard models were additionally applied to account for competing risks. Results: Over a median follow-up duration of 13.1 [interquartile range (IQR), 10.3-16.3] years, the incidence rate of NTM-PD was not significantly different, showing 54.82 and 43.21 per 100,000 person-years (PY) in the overall IBD and matched cohorts, respectively. In multivariable Cox-regression analysis, the risk of NTM-PD was not significantly increased in the IBD cohort compared to the matched controls (adjusted HR =1.12, 95% CI: 0.82-1.54). Also, in Fine-Gray model, the risk of NTM-PD was not significantly increased in the IBD cohort compared to the matched controls (adjusted HR =1.16, 95% CI: 0.85-1.59). Neither Crohn's disease nor ulcerative colitis was associated with increased risk of NTM-PD (adjusted HR =0.98, 95% CI: 0.52-1.84 for Crohn's; adjusted HR =1.26, 95% CI: 0.88-1.81 for ulcerative colitis Conclusions: In this nationwide, large, longitudinal study, IBD was not associated with increased risk of NTM-PD.
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