Inflammatory bowel disease and the risk of cardiovascular diseases

Núñez, Paulina; Mateo, Sandra García; Quera, Rodrigo; Gomollón, Fernando

doi:10.1016/j.gastre.2021.02.003

Cited by 10 publications

(9 citation statements)

References 59 publications

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“…JAKi are approved for several IMIDs that are diverse regarding their epidemiology and baseline CV risk. [48][49][50][51][52][53][54][55][56][57] Although RA, PsA, AS, UC, and axial spondylarthritis are clearly associated with CV disease, research is ongoing regarding CV risk in AA, AD, polyarticular course JIA, and vitiligo. [48][49][50][51][52][53][54][55][56][57] The heterogeneity in patient characteristics of those using JAKi in the real-world is highlighted by Table 1, which summarizes demographics in seminal phase 3 trials.…”

Section: Evidence Across Indicationsmentioning

confidence: 99%

“…48–57 Although RA, PsA, AS, UC, and axial spondylarthritis are clearly associated with CV disease, research is ongoing regarding CV risk in AA, AD, polyarticular course JIA, and vitiligo. 48–57 The heterogeneity in patient characteristics of those using JAKi in the real-world is highlighted by Table 1, which summarizes demographics in seminal phase 3 trials. Table 1 highlights the great variability in mean/median patient age, ranging from 11.9 to 57.1 years.…”

Section: The Unanswered Questions About the Cardiovascular Safety Pro...mentioning

confidence: 99%

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Cardiovascular Risk Management in Patients Treated With Janus Kinase Inhibitors

Shah,

Femia

et al. 2024

Journal of Cardiovascular Pharmacology

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The Janus kinase (JAK)-signal transducer and activator of transcription (STAT) pathway plays a critical role in the pathogenesis of many immune-mediated inflammatory diseases (IMIDs). Although Janus kinase inhibitors (JAKi) are an effective treatment for several IMIDs, they have come under scrutiny as a class due to a potential risk of venous thromboembolism (VTE) and cardiovascular (CV) events, specifically noted with the oral JAKi, tofacitinib, as reported in the ORAL Surveillance Trial of a high CV risk rheumatoid arthritis population. This trial resulted in a black box warning from the Food and Drug Administration and European Medicines Agency regarding risk of VTE and CV events that was extended across several types of JAKi (including topical ruxolitinib) when treating IMIDs, leading to considerable controversy. Included is an up-to-date review of the current and rapidly evolving literature on CV risk in patients with IMIDs on JAKi therapy, including identification of potential risk factors for future VTE and CV events on JAKi therapy. We suggest a comprehensive, multimodal, and systematic approach for evaluation of CV risk in patients considering taking JAKi and emphasize that cardiologists play an important role in risk stratification and mitigation for patients with high CV risk factors or on long-term JAKi therapies.

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Section: Evidence Across Indicationsmentioning

confidence: 99%

Section: The Unanswered Questions About the Cardiovascular Safety Pro...mentioning

confidence: 99%

Cardiovascular Risk Management in Patients Treated With Janus Kinase Inhibitors

Shah,

Femia

et al. 2024

Journal of Cardiovascular Pharmacology

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“…IBD is also associated with several comorbidities such as osteoporosis, Parkinson's disease, atherosclerosis and cardiovascular disease [10]. In fact, it has been reported that IBD patients have an increased cardiovascular risk [11,12], possibly because chronic systemic inflammation promotes atherosclerotic events [13]. Given the systemic inflammatory nature of IBD and the increased cardiovascular risk, many IBD patients are under concomitant anti-hypertensive therapy with ACE inhibitors (ACEi) or angiotensin receptor blockers (ARBs).…”

Section: Introductionmentioning

confidence: 99%

Heterogeneity in protocols and outcomes to study the effect of renin‐angiotensin system blockers in inflammatory bowel disease: A systematic review

Ferreira‐Duarte

Tonin

Duarte‐Araújo

et al. 2023

Fundamemntal Clinical Pharma

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BackgroundThe renin‐angiotensin system (RAS) has been associated with inflammatory bowel disease (IBD), supporting translational relevance of RAS blockers. Comparability of study design/outcomes is fundamental for data analysis/discussion.ObjectivesWe aimed at evaluating the heterogeneity among protocols and outcomes to study the effect of angiotensin‐converting enzyme inhibitors or angiotensin receptor blockers in IBD.MethodsThis study was performed and reported in accordance with the Cochrane recommendations and PRISMA (PROSPERO‐CRD42022323853). Systematic searches were performed in PubMed, Scopus and Web of Science. Studies that met the inclusion criteria were selected. Quality assessment of the studies was done with the SYRCLES's risk of bias tools for animal studies.ResultsThirty‐five pre‐clinical studies and six clinical studies were included. Chemical induction of colitis was the most used model, but variable doses of the induction agent were reported. All studies reported at least a disease activity index, a macroscopic score, or a histologic assessment, but these scores were methodologically heterogeneous and reported for different characteristics. Great heterogeneity was also found in drug interventions. Inflammatory markers assessed as outcomes were different across studies.ConclusionLack of standardization of protocols and outcomes among studies threatens the evidence on how RAS blockers influence IBD outcomes.

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“…Although UC has been reported to be a risk factor for AMI progression [11], the relationship between these two diseases remains controversial. Osterman et al [12] have concluded that patients with UC do not have elevated AMI incidence.…”

Section: Introductionmentioning

confidence: 99%

Uncovering the Genetic Link between Acute Myocardial Infarction and Ulcerative Colitis Co-Morbidity through a Systems Biology Approach

Cui¹,

Cai²,

Wu³

et al. 2023

CVIA

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Background: Cardiovascular diseases, particularly acute myocardial infarction, are the leading cause of disability and death. Atherosclerosis, the pathological basis of AMI, can be accelerated by chronic inflammation. Ulcerative colitis (UC), a chronic inflammatory disease associated with immunity, contributes to the risk of AMI development. However, controversy continues to surround the relationship between these two diseases. The present study unravels the pathogenesis of AMI and UC, to provide a new perspective on the clinical management of patients with these comorbidities. Methods: Microarray datasets GSE66360 and GSE87473 were downloaded from the Gene Expression Omnibus database. Common differentially expressed genes (co-DEGs) between AMI and UC were identified, and the following analyses were performed: enrichment analysis, protein-protein interaction network construction, hub gene identification and co-expression analysis. Results: A total of 267 co-DEGs (233 upregulated and 34 downregulated) were screened for further analysis. GO enrichment analysis suggested important roles of chemokines and cytokines in AMI and UC. In addition, the lipopolysaccharide-mediated signaling pathway was found to be closely associated with both diseases. KEGG enrichment analysis revealed that lipid and atherosclerosis, NF-κB, TNF and IL-17 signaling pathways are the core mechanisms involved in the progression of both diseases. Finally, 11 hub genes were identified with cytoHubba: TNF, IL1B, TLR2, CXCL8, STAT3, MMP9, ITGAX, CCL4, CSF1R, ICAM1 and CXCL1. Conclusion: This study reveals a co-pathogenesis mechanism of AMI and UC regulated by specific hub genes, thus providing ideas for further mechanistic studies, and new perspectives on the clinical management of patients with these comorbidities.

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Inflammatory bowel disease and the risk of cardiovascular diseases

Cited by 10 publications

References 59 publications

Cardiovascular Risk Management in Patients Treated With Janus Kinase Inhibitors

Cardiovascular Risk Management in Patients Treated With Janus Kinase Inhibitors

Heterogeneity in protocols and outcomes to study the effect of renin‐angiotensin system blockers in inflammatory bowel disease: A systematic review

Uncovering the Genetic Link between Acute Myocardial Infarction and Ulcerative Colitis Co-Morbidity through a Systems Biology Approach

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