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P204 Lipid profile in inflammatory bowel disease under maintenance wih anti-TNF: a prospective longitudinal cohort study

Ferreiro R., Lopez-Diaz J., Lorenzo A., Dominguez-Munoz J.E., Barreiro-de Acosta M.

University Hospital Santiago de Compostela, Gastroenterology, Santiago, Spain

Background

The role of tumor necrosis factor (TNF) inhibitor in patients with inflammatory bowel disease (IBD) in mediating cardiovascular risk and changing lipid profile is controversial. The aimof the study was to evaluate the effect of anti-TNF monoclonal antibodieson lipid profile in IBD patients

Methods

A prospective, observational cohort study was designed. Inclusion criteria were consecutive IBD patients in clinical remission for at least six months under a continuous standard dose of 40mg/eowadalimumab therapy or 5mg/kg infliximab therapy every 8 weeks. Relapse was defined as a Harvey–Bradshaw score >4 in Crohn's disease and a partial Mayo score>3 in ulcerative colitis. Hypercholesterolemia was defined as a cholesterol count above 200and hypertriglyceridemia was defined as a triglyceridemia count above 150. Theywere quantified at 4-month intervals for one year. All patients completed a basal demographic and clinical questionnaire. Differences between laboratory results were evaluated with paired samples T test in cholesterol (normal distribution) and with nonparametric test with in triglycerides (not normal distribution).

Results

95 consecutive patients were included. The median age was 44 years (18–78), 51% female and 75% with CD.10.6% of patients presented arterial hypertension, 3.3% mellitus diabetes and 3.1% a previous cardiovascular event. 65 (68.4%) patients remained in clinical remission and 30 (31.6%) suffered from a relapse during the follow-up period. We compared lipid profile between month 0 and month 12, almost statically significant differences were noted in triglycerides (p=0.05) but not differences in cholesterol (p>0.5). There was not a statistically significant difference in lipid profile during the follow-up, the subgroup with relapse showed a not significant increased in both cholesterol and triglycerides.

Table 1. Triglycerides profile modification according to relapse (median, range)

Month 0Month 4Month 8Month 12
Remission88 (33–407)98 (38–483)101 (32–801)100 (29–442)
Relapse103 (40–189)71 (33–240)110 (44–214)121 (44–353)

Table 2. Cholesterol profile modification according to relapse (mean, standard deviation)

Month 0Month 4Month 8Month 12
Remission178 (31.8)178 (35.5)181 (35.5)180 (38.6)
Relapse172 (34.5)176 (38.0)172 (32.1)176 (38.1)

Conclusion

In IBD patients under maintenance therapy with anti-TNF, triglycerides increased almost significantly after one year of follow-up. Anti-TNF therapy can have a role in changes in the lipid profile, but without clinical relevance.