P783 Exploring the impact of JAK Inhibitors on cholesterol levels in Patients with Inflammatory Bowel Disease: A Real-World Data Analysis

Abstract

Abstract Background Janus Kinase (JAK) inhibitors represent a significant therapeutic advancement for individuals with inflammatory bowel disease (IBD). Previous research indicates an increase in total cholesterol (total-c) upon the initiation of JAK therapy.1The precise mechanisms remain unclear, but studies suggest that inflammation can lower lipid levels. Therefore, by addressing inflammation through JAK therapy, there may be a subsequent elevation in lipid levels. This study seeks to evaluate the impact of initiating JAK inhibitors on total cholesterol levels in patients with IBD, utilising real-world data for analysis. Methods A multi-site retrospective analysis was conducted on a cohort of patients with ulcerative colitis and Crohn’s disease who had been initiated on either filgotinib, tofacitinib or upadacitinib. Statistical analysis was applied to examine alterations in total cholesterol levels (total-c) before and after the initiation of JAK inhibitor therapy. Results A cohort of 49 patients was identified, with pre and post total-c levels available for 33 individuals included in the analysis. Utilising paired data and the Student's t-test, we examined whether initiating a JAK inhibitor led to increased total cholesterol levels. Patients commenced on tofacitinib and upadacitinib exhibited statistically significant increases in cholesterol (p=0.016, p=0.0001). Patients in the filgotinib group, although demonstrating rises in total-c in most cases, did not reach statistical significance (p=0.21). Graph 1 demonstrates the range and spread of the results. Upadacitinib increased cholesterol levels by the most on average (0.82), compared to tofacitinib (0.64) or filgotinib (0.3). Elevated cholesterol persisted beyond 12 weeks in some patients, but long-term data for all patients was not available. Notably, only one patient initiated a statin, resulting in lipid normalisation at the next assessment. No cardiac events were identified in this cohort. Conclusion This analysis of real-world data underscores a potential influence of JAK inhibitors on the cholesterol profiles of individuals with inflammatory bowel disease (IBD). Gaining insights into the interplay between JAK inhibitors and lipid metabolism within the realm of IBD treatment is essential for enhancing patient care and proactively addressing potential cardiovascular risks linked to these therapeutic interventions. 1.Herrera-deGuise C, Serra-Ruiz X, Lastiri E and Borruel N (2023) JAK inhibitors: A new dawn for oral therapies in inflammatory bowel diseases. Front. Med. 10:1089099. doi: 10.3389/fmed.2023.1089099