Type of publication:

Conference abstract

Author(s):

Bharadwaj H.; Perros I.; Biggs D.; *Butterworth J.; Gohar F.; Sokhal B.S.; Mallen C.

Citation:

United European Gastroenterology Journal. Conference: The 33rd United European Gastroenterology Week, UEGW 2025. Berlin Germany. 13(Supplement_8) (pp 628), 2025. Date of Publication: 01 Oct 2025.

Abstract:

Introduction: Biologic therapies are the preferred treatment for induction and maintenance of remission in Crohn's Disease, although their cardiovascular safety remains uncertain. This systematic review and meta-analysis aimed to estimate the risk of major adverse cerebrovascular and cardiovascular events (MACCEs) in adult CD patients receiving biologic or small molecule therapies in randomised controlled trials (RCTs). Aims & Methods: This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. MEDLINE, EMBASE, and Cochrane were searched to identify RCTs that assessed the risk of MACCEs in CD induction and maintenance trials. Data were pooled and analysed using random effects modelling with 95% confidence intervals (CIs). Result(s): 40 RCTs were included, describing 20 induction and 20 maintenance trials. A total of 17,718 patients were included, with 11,148 (62.9%) receiving biologic agents or small molecules. The risk of MACCEs was lower in induction (OR=0.56, 95%CI: 0.24,1.34, P=0.19) and maintenance trials (OR=0.75, 95%CI: 0.35,1.57, P=0.44) compared to placebo or active comparators. MACCE risk remained unaffected by drug agent, drug class, and trial duration. Overall, there was no difference in MACCE risk based on receipt of biological therapy (OR=0.65, 95%CI: 0.37,1.15, P=0.14). Conclusion(s): Biologic agents and small molecules did not increase MACCE risk in CD induction and maintenance trials. A slight cardioprotective effect was observed. Longer follow-up studies with real-world data are required to confirm these findings outside the RCT setting.

DOI: 10.1002/ueg2.70032

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