Journal Article

Asymptomatic hyperCKemia During Infliximab Therapy in Patients With Inflammatory Bowel Disease

Eirini Theodoraki, Eleni Orfanoudaki, Kalliopi Foteinogiannopoulou and Ioannis E Koutroubakis

in Inflammatory Bowel Diseases

Volume 24, issue 6, pages 1266-1271
Published in print May 2018 | ISSN: 1078-0998
Published online April 2018 | e-ISSN: 1536-4844 | DOI: https://dx.doi.org/10.1093/ibd/izy088
Asymptomatic hyperCKemia During Infliximab Therapy in Patients With Inflammatory Bowel Disease

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  • Gastro-intestinal and Colorectal Surgery

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Abstract

Background

Both muscle-related complaints and elevated serum creatine kinase (CK) levels have been reported in patients with inflammatory bowel disease (IBD) treated with infliximab (IFX), mainly as case reports. The aim of this study was to investigate the effect of IFX therapy on serum CK levels in a cohort of Greek IBD patients.

Methods

Demographic, clinical (including muscle complaints), and laboratory data of consecutive IBD patients undergoing IFX treatment and a matched control group of IBD patients without any use of biological treatment were retrospectively analyzed. In both groups, patients having at least 3 CK measurements, with at least 10 days’ interval among them, were included.

Results

The IFX-treated IBD patient group included 82 individuals (75.6% Crohn’s Disease [CD]; mean age, 44.7 ± 13.3 years; 60.9% men; median [interquartile range {IQR}] duration of IFX treatment, 27 [12–84] months). Eighty-two patients without treatment with any biological agent formed the control group (62.2% CD; mean age, 50.4 ± 16.4 years; 59.8% men). Twenty-five IFX-treated patients (30.5%) had elevated mean serum CK levels (>180 U/L), compared with 9 (11%) in the control group (P = 0.0003). The median CK value in the IFX group (123.5 U/L; IQR, 91–190.75) was significantly higher than that of the control group (81 U/L; IQR, 57–112.75; P < 0.0001). In the logistic regression analysis, the presence of hyperCKemia was independently correlated with the use of IFX (odds ratio, 4.03; IQR, 1.64–9.90; P = 0.002). No patient with hyperCKemia in both groups reported any persistent symptom of myopathy.

Conclusions

More than 30% of IBD patients on IFX present asymptomatic persistent and treatment-related hyperCKemia. Further relevant prospective investigation is needed.

10.1093/ibd/izy088_video1 izy088.video1 5778459427001

Keywords: creatine kinase; infliximab; Crohn’s disease; ulcerative colitis

Journal Article.  3312 words.  Illustrated.

Subjects: Medicine and Health ; Clinical Medicine ; Gastroenterology ; Patient Education and Information ; Gastro-intestinal and Colorectal Surgery

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