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P081. Effect of condroitin sulphate on pro-inflammatory mediators and disease activity in patients with inflammatory bowel disease (IBD)

P.M. Linares1, M. Chaparro1, A. Algaba2, M. Román3, I. Moreno Arza3, F. Abad Santos3, D. Ochoa3, F. Bermejo2, J.P. Gisbert1, 1Hospital Universitario de la Princesa-IP, Gastroenterology and CIBEREHD, Madrid, Spain, 2Hospital Universitario de Fuenlabrada, Gastroenterology, Fuenlabrada, Spain, 3Hospital Universitario de la Princesa-IP, Clinical Pharmacology and CIBEREHD, Madrid, Spain

Background

Condroitin sulphate (CS), a glycosaminoglycan that modulates NF-κB, might modulate several pro-inflammatory proteins involved in the pathogenesis of IBD. In order to investigate the impact of CS on the clinical course of IBD, its effect on the concentrations of these molecules in serum and urine was assessed.

Methods

Prospective observational 12-month (m) follow-up study in patients with IBD in remission for at least 6 m, starting CS (Condrosan®, Bioibérica S.A., Barcelona, Spain) treatment for osteoarthritis (OA). Visits were as follows: Baseline, 3rd, 6th, 9th and 12th m. CDAI and modified Truelove–Witts clinical indexes were calculated for Crohn's disease (CD) and ulcerative colitis (UC) respectively. Orosomucoid, C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were also determined. Levels of VEGFA, VEGFC, FGF2, HGF, Ang1, Ang2, TGFβ, TNFα, IL1β, -6, -12, -17, -23, ICAM1, VCAM1, MMP3 and PGE2 were quantified by ELISA. OA joint pain was evaluated by a visual analogue scale. The study is still ongoing.

Results

At present, 29 patients with IBD (16 UC, 13 CD) have been included. Mean age was 62 years, and 72% were women. The mean disease duration was 14 years. 69% of patients were under mesalazine, 3% with sulfasalazine, 14% with thipourines, and 3% with methotrexate. There was only one patient (with UC) that had a flare during follow-up (6th m visit). The incidence rate of relapse was 4.7% per patient-year of follow-up. That figure seems lower than the relapse rate previously reported for IBD patients. 8 UC and 5 CD patients have completed the 12 m follow-up. In CD, IL1β increased (from 1.24 to 2.07 pg/mL) and Ang2 levels decreased (from 3.19 to 2.68 ng/mL) between baseline and the 6th m visit (P < 0.05). In UC patients, VEGFA decreased between baseline (339 pg/mL) and the 6th m visit (236 pg/mL) (P < 0.05). Further differences regarding the other studied pro-inflammatory markers were not found. At 12th m, the OA joint pain had improved in all patients (P < 0.01). 30% of patients suffered adverse events, but only 6% were related to the drug.

Conclusion

The incidence of IBD relapse in patients under CS treatment was lower than the generally reported. CS treatment might modulate VEGFA, IL1β and Ang2 serum levels, but it is not associated with modifications in the concentrations of the other studied pro-inflammatory mediators. CS decreases pain related to OA in patients with IBD.