Advanced biologic therapies and cardiovascular events in patients with inflammatory bowel disease

Aims

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.

Methods

Retrospective cohort study using the TriNetX Network

Results

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 p < 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.

Conclusions

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.