PhD Scientific Days 2023

Clinical Medicine VI.

The effect of tumor necrosis factor inhibitors on the risk of cardiovascular events in immune-mediated inflammatory diseases: preliminary result from a systematic review and meta-analysis

Előadó neve

Dr. Vámosi-Galajda, Noémi Ágnes

Neptun code

Q1FEQZ

Előadó munkahelye

Department of Dermatology, Venereology and Dermatooncology

Előadó telefonszáma

+36304196934

Előadó e-mail címe

noemigalajda@gmail.com

Az előadás címe

The effect of tumor necrosis factor inhibitors on the risk of cardiovascular events in immune-mediated inflammatory diseases: preliminary result from a systematic review and meta-analysis

Szerző(k) neve és munkahelye

Noémi Ágnes Galajda, 1. Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 2. Centre for Translational Medicine, Semmelweis University

Bemutatás módja

Szóbeli

Szekció

Clinical Medicine VI.

Language of the presentation

English

Preferred session

Clinical Medicine

Összefoglaló szövege

Introduction
Immune-mediated inflammatory diseases (IMIDs) refer to a broad group of conditions, the most common manifestations of which include rheumatoid arthritis (RA), psoriasis (Pso), spondylarthritis (SpA), and inflammatory bowel diseases (IBD). Patients affected by IMIDs have a higher risk of developing atherosclerotic cardiovascular (CV) diseases compared to the general population. The increased risk may be promoted by the cytokine tumor necrosis factor alpha (TNF-α), which is involved in the inflammatory processes of both IMID and atherosclerosis. Biological therapies targeting TNF-α may have a favorable effect on cardiovascular risk compared to conventional agents used in IMIDs, which do not act through this common inflammatory pathway.

Aims
Our aim was to investigate the effect of TNF-inhibitor therapies on the risk of the occurrence of cardiovascular events compared with conventional non-biological therapies.

Method
The systematic literature search was conducted in three databases (MEDLINE, EMBASE, Cochrane Library). Studies with IMID patient population comparing TNF-inhibitors with conventional systemic non-biologicals (CSNBs) were included. Our outcomes were cardiovascular events and their composite endpoints. We performed a random-effects meta-analysis; multivariate hazard ratios (HRs) with a 95% confidence interval (CI) were pooled.

Results
The systematic search resulted in 8724 hits, of which 53 studies were found eligible after the selection process. The preliminary result of our meta-analysis was obtained by pooling the data from 15 observational studies measuring the risk of major adverse cardiovascular events (MACE), myocardial infarction (MI) and cerebrovascular events (CeVE). As compared to CSNBs, the use of TNF-inhibitors was associated with a significantly decreased risk of MACE (HR 0.74 [0.61-0.89]), MI (HR 0.66 [0.50-0.87]) and CeVE (HR 0.75 [0.64-0.89]).

Conclusion
TNF-inhibitors can reduce the risk of cardiovascular events compared to CSNB therapies in IMIDs. Therefore, we urge the use of TNF-inhibitors as first-line agents in patients with high cardiovascular risk to reduce CV-related mortality.

Funding
SU 250+ Excellence Scholarship

University and Doctoral School

Semmelweis University, Károly Rácz Doctoral School of Clinical Medicine

Supervisor

Prof. Dr. Péter Holló, Dr. András Bánvölgyi, PhD

Publication of my abstract

I do not give consent to the publication of my abstract on the website of the congress.

Kind

Szabad

Status

elfogadva

Accepted presentation method

szóbeli

Előadás fájl jóváhagyás

nem rendelkezett róla

Előadó

7437

Start

09:45

End

10:00

Authors (legacy)

Noémi Ágnes Galajda, 1. Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 2. Centre for Translational Medicine, Semmelweis University