Chaaban Lara, Harb Tarek, Gerstenblith Gary, Leucker Thorsten M, Melia Joanna
Division of Gastroenterology and Hepatology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Am J Prev Cardiol. 2025 Apr 24;22:100991. doi: 10.1016/j.ajpc.2025.100991. eCollection 2025 Jun.
Atherosclerotic cardiovascular disease (ASCVD) risk is increased in patients with Inflammatory Bowel Disease (IBD). The impact of advanced biologic therapies (ABT) on ASCVD risk in patients with IBD has not been reported. This study tests the hypothesis of a protective effect of immune modulation with ABT on ASCVD risk in patients with IBD.
Retrospective cohort study using the TriNetX Network.
This analysis included 72,650 individuals in each of two matched cohorts with IBD: one receiving ABT and one receiving non-ABT (NABT). The probabilities of experiencing an ischemic cardiovascular, cerebrovascular, or peripheral vascular event were all significantly lower in the ABT group, than in the NABT group. The probabilities of any ASCVD event at one, three, and five years in the ABT group were also lower than in the NABT group (8.3 % vs. 11.9 %, OR 0.67; 13.0 % vs. 17.9 %, OR 0.69; and 15.0 % vs. 21.2 %, OR 0.68; respectively, all < 0.01). The reduced risk was strongest with the interleukin 12/23 inhibitors when compared with the other drug subclasses with an OR of 0.37 [0.32-0.42] when compared to the NABT group.
ABT were associated with significantly fewer ASCVD events than NABT in the IBD patient population. Among drug subclasses, interleukin 12/23 inhibitors were associated with the strongest benefit. Future prospective, randomized studies examining the efficacy and safety as well as the differential benefit of drug subclasses on ASCVD outcomes and mechanisms responsible for the ABT benefit are needed.
炎症性肠病（IBD）患者的动脉粥样硬化性心血管疾病（ASCVD）风险增加。先进生物疗法（ABT）对IBD患者ASCVD风险的影响尚未见报道。本研究检验了ABT免疫调节对IBD患者ASCVD风险具有保护作用这一假设。
使用TriNetX网络进行回顾性队列研究。
该分析纳入了两个匹配的IBD队列中的每一个队列中的72650名个体：一个接受ABT，另一个接受非ABT（NABT）。ABT组发生缺血性心血管、脑血管或外周血管事件的概率均显著低于NABT组。ABT组在1年、3年和5年时发生任何ASCVD事件的概率也低于NABT组（分别为8.3%对11.9%，OR 0.67；13.0%对17.9%，OR 0.69；15.0%对21.2%，OR 0.68；均<0.01）。与其他药物亚类相比，白细胞介素12/23抑制剂降低风险的作用最强，与NABT组相比，OR为0.37[0.32 - 0.42]。
在IBD患者群体中，ABT与ASCVD事件显著少于NABT相关。在药物亚类中，白细胞介素12/23抑制剂的获益最强。未来需要进行前瞻性、随机研究，以检验疗效和安全性以及药物亚类对ASCVD结局的差异获益和ABT获益的相关机制。
