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Heart Under Pressure: Divergent Cardiac Molecules Responses to Azathioprine and Anti-TNF Therapy in Ulcerative Colitis.

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Title: Heart Under Pressure: Divergent Cardiac Molecules Responses to Azathioprine and Anti-TNF Therapy in Ulcerative Colitis.
Authors: Cvetković, Mirjana, Simović, Stefan, Radojević, Dušan, Maksić, Mladen, Zdravković, Nataša, Milošević, Bojan, Stojanović, Bojan, Stolić, Radojica, Todorović, Željko, Gogić, Anđela, Zdravković, Nebojša, Zdravković, Mateja
Source: International Journal of Molecular Sciences; Oct2025, Vol. 26 Issue 20, p10160, 11p
Subject Terms: AZATHIOPRINE, CREATINE kinase, ULCERATIVE colitis, BIOMOLECULES, HEART physiology, BIOTHERAPY, MEDICAL research, BRAIN natriuretic factor
Abstract: The treatment of moderate-to-severe ulcerative colitis often requires escalation from 5-ASA therapy to immunosuppressants or biologic agents. However, the effects of azathioprine and anti-TNF therapies on cardiac status and associated biomolecules remain insufficiently studied. In this prospective observational study, we included 84 patients with moderate-to-severe ulcerative colitis, divided into three treatment groups based on the therapy received (azathioprine, infliximab, or adalimumab), along with 25 healthy controls. Levels of proBNP, NT-proBNP, creatine kinase (CK), CK-MB, and high-sensitivity troponin I (hsTnI) were measured at baseline, 6 h after treatment initiation, and after 3 months of therapy. Troponin levels did not significantly change across the three time points in any treatment group. In contrast, levels of proBNP, NT-proBNP, CK, and CK-MB significantly decreased after 3 months in patients treated with biologics, whereas a significant increase was observed in the azathioprine group. Further prospective trials are needed to adequately assess the cardiac safety of these therapies, particularly in patients with preexisting cardiac impairment. [ABSTRACT FROM AUTHOR]
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Database: Complementary Index
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Abstract:The treatment of moderate-to-severe ulcerative colitis often requires escalation from 5-ASA therapy to immunosuppressants or biologic agents. However, the effects of azathioprine and anti-TNF therapies on cardiac status and associated biomolecules remain insufficiently studied. In this prospective observational study, we included 84 patients with moderate-to-severe ulcerative colitis, divided into three treatment groups based on the therapy received (azathioprine, infliximab, or adalimumab), along with 25 healthy controls. Levels of proBNP, NT-proBNP, creatine kinase (CK), CK-MB, and high-sensitivity troponin I (hsTnI) were measured at baseline, 6 h after treatment initiation, and after 3 months of therapy. Troponin levels did not significantly change across the three time points in any treatment group. In contrast, levels of proBNP, NT-proBNP, CK, and CK-MB significantly decreased after 3 months in patients treated with biologics, whereas a significant increase was observed in the azathioprine group. Further prospective trials are needed to adequately assess the cardiac safety of these therapies, particularly in patients with preexisting cardiac impairment. [ABSTRACT FROM AUTHOR]
ISSN:16616596
DOI:10.3390/ijms262010160