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Anti-TNFs linked with decreased risk for acute arterial events in IBD
Exposure to anti-TNF reduced the risk for acute arterial events in patients with inflammatory bowel disease, according to results of a large, nationwide study in France.
Julien Kirchgesner, MD, PhD, of the department of gastroenterology at Hôpital Saintantoine in France, and colleagues wrote that patients with IBD are at increased risk for arterial events that could be mitigated by common therapies used for the disease.
“The impact of anti-TNFs and thiopurines on the risk of acute arterial events in patients with IBD remains largely unexplored, potentially due to a lack of statistical power in most IBD populations, as seen in previous studies,” they wrote. “As long as the potential protective effect of IBD-related treatment is not well established, an efficient prevention strategy cannot be elaborated.”
Researchers followed 177,827 patients with IBD (54% women; mean age 46.2 years) in the French national health insurance system for approximately 4 years and compared the risks for arterial events, like ischemic heart disease, cerebrovascular disease and peripheral heart disease, between patients who were exposed to anti-TNF or thiopurines with patients exposed to neither.
During the follow-up period, researchers identified 4,145 cases of acute arterial events (incidence rate = 5.4 per 1,000 person-years).
Compared with patients who were not exposed to therapy, exposure to anti-TNF was associated with decreased risk for acute arterial events (HR = 0.79; 95% CI, 0.66–0.95). However, exposure to thiopurines was not (HR = 0.93; 95% CI, 0.82–1.05).
Investigators observed the biggest risk reduction among men with Crohn’s disease exposed to anti-TNF (HR = 0.54; 95% CI, 0.4–0.72).
“Notably, this risk reduction was highest in men with CD treated with anti-TNFs,” Kirchgesner and colleagues wrote. “Prevention of acute arterial events should be considered in the benefit–risk balance assessment of thiopurines and anti-TNFs in patients with IBD.” – by Alex Young
Disclosures: Kirchgesner reports no relevant financial disclosures. Please see the full study for all other authors’ relevant financial disclosures.