Sutter Manuel, Hruz Petr, Niess Jan Hendrik
Department of Biomedicine, University of Basel, Basel, Switzerland.
Clarunis - University Center for Gastrointestinal and Liver Diseases, St. Clara Hospital and University Hospital of Basel, Basel, Switzerland.
Inflamm Intest Dis. 2021 Aug 26;6(3):165-174. doi: 10.1159/000518264. eCollection 2021 Sep.
TNF inhibitors are relatively safe drugs, but asymptomatic infliximab-induced high serum creatine kinase (CK) levels have been reported in >30% of patients with inflammatory bowel disease (IBD). Whether high serum CK levels are a specific effect of treatment with TNF inhibitors has not been studied in detail. CK levels were therefore compared between infliximab- and vedolizumab-treated IBD patients.
In this retrospective, monocentric study, 131 IBD cases (82 with Crohn's disease (CD), 49 with ulcerative colitis) of the Basel University Hospital IBD cohort treated either with infliximab or vedolizumab were included. Serum samples for measuring CK, lactate dehydrogenase (LDH), C-reactive protein (CRP), and fecal calprotectin (FCal) levels were collected longitudinally and analyzed using mixed additive models.
No significant differences in CK levels between infliximab and vedolizumab-treated patients were observed over time. Infliximab-treated males, however, showed significantly higher CK levels than females and former smokers treated with infliximab showed significantly lower CK levels than nonsmokers. No such differences were observed in vedolizumab-treated patients. LDH and CRP were not significantly different between infliximab- and vedolizumab-treated patients, while adjusted groups showed substantially higher LDH levels with increasing age and significantly lower LDH levels in patients with longer disease duration. Infliximab patients with CD showed significantly lower CRP. However, significantly higher FCal concentrations were noted in infliximab patients independent of diagnosis, gender, disease duration, smoking behavior, and age.
In our cohort, high serum CK levels are not an infliximab- or vedolizumab-specific effect.
肿瘤坏死因子（TNF）抑制剂是相对安全的药物，但在超过30%的炎症性肠病（IBD）患者中报告了英夫利昔单抗诱导的无症状性高血清肌酸激酶（CK）水平。血清CK水平升高是否是TNF抑制剂治疗的特异性效应尚未得到详细研究。因此，对接受英夫利昔单抗和维多珠单抗治疗的IBD患者的CK水平进行了比较。
在这项回顾性单中心研究中，纳入了巴塞尔大学医院IBD队列中131例接受英夫利昔单抗或维多珠单抗治疗的IBD病例（82例克罗恩病（CD），49例溃疡性结肠炎）。纵向收集用于测量CK、乳酸脱氢酶（LDH）、C反应蛋白（CRP）和粪便钙卫蛋白（FCal）水平的血清样本，并使用混合加法模型进行分析。
随着时间的推移，未观察到英夫利昔单抗和维多珠单抗治疗患者的CK水平有显著差异。然而，接受英夫利昔单抗治疗的男性CK水平显著高于女性，接受英夫利昔单抗治疗的既往吸烟者CK水平显著低于非吸烟者。在接受维多珠单抗治疗的患者中未观察到此类差异。英夫利昔单抗和维多珠单抗治疗患者的LDH和CRP无显著差异，而调整后的组显示随着年龄增长LDH水平显著升高，病程较长的患者LDH水平显著降低。患有CD的英夫利昔单抗患者CRP显著较低。然而，无论诊断、性别、病程、吸烟行为和年龄如何，英夫利昔单抗患者的FCal浓度均显著较高。
在我们的队列中，高血清CK水平不是英夫利昔单抗或维多珠单抗的特异性效应。
