EARLY ANTI-TUMOR NECROSIS FACTOR THERAPY REDUCES AORTIC STIFFNESS IN INFLAMMATORY BOWEL DISEASE. A MULTICENTRE LONGITUDINAL STUDY : Journal of Hypertension

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EARLY ANTI-TUMOR NECROSIS FACTOR THERAPY REDUCES AORTIC STIFFNESS IN INFLAMMATORY BOWEL DISEASE. A MULTICENTRE LONGITUDINAL STUDY

Zanoli, L.1; Inserra, G.1; Cappello, M.2; Ozturk, K.3; Castellino, P.1

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Journal of Hypertension 37():p e35, July 2019. | DOI: 10.1097/01.hjh.0000570712.90744.fb
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Abstract

Objective: 

In patients with inflammatory bowel disease (IBD) the cardiovascular risk is increased despite the low prevalence of traditional cardiovascular risk factors. We have previously reported in IBD that aortic pulse wave velocity (aPWV) is increased and dependent upon chronic inflammation, and that aPWV is reduced by long-term anti-tumor necrosis factor (anti-TNF) therapy and is increased in patients with severe inflammation and in those treated with high doses of salicylates. Here, we aimed to test the hypothesis that aortic stiffening is more easily reverted by long-term anti-TNF therapy within few years from the diagnosis of IBD, when structural alterations of the arterial wall could be not yet fully established.

Design and method: 

Multicentre longitudinal study. A total of 167 patients with IBD from 3 Centres in Europe were enrolled and followed up for 4 years (range 3–6 years).

Results: 

Long-term anti-TNF therapy reduced aPWV in patients with a recent diagnosis of IBD (<4 years, P = 0.01) and remained almost unchanged in those with a longer disease duration (>4 years, P = 0.15) (Figure 1, bars represent means and SEM), suggesting that, in patients with IBD, the protective effect of anti-TNF therapy on the aortic wall could be explicated, at least in part, by the reduction of functional aortic stiffening, as previously suggested in other models of chronic severe inflammation.

Image

Bars represent means and SEM

Conclusions: 

In conclusion, anti-TNF therapy is useful to revert aortic stiffening in patients with a recent diagnosis of IBD and to block aortic stiffening in those with a longer disease duration (>4 years).

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