Infliximab Not Associated With Increased Cardiovascular Risk in Bipolar Disorder

In bipolar disorder (BD), infliximab had little effect on cardiovascular outcomes, according to results of a study published in the Journal of Affective Disorders.

This post hoc analysis evaluated data from a randomized, double-blind, placebo-controlled, parallel group clinical trial. Between 2015 and 2018, patients with BD treated at the University Health Network in Canada and Stanford University in the United States were randomized to receive 5 mg/kg infliximab (n=19) or placebo (n=21) for 12 weeks. In this analysis, the effect of infliximab on cardiovascular disease (CVD) risk factors were evaluated.

The infliximab and control cohorts were aged mean 45.0 (SD, 11.7) and 46.6 (SD, 10.1) years respectively. A total of 68% and 86% were women respectively, 63% and 57% were taking antipsychotic medications respectively, 53% and 57% were taking antidepressants, and 53% and 38% were taking mood stabilizers, respectively.

Framingham risk scores (FRS) did not change over time (χ², 0.437; P =.508) nor were there treatment effects (χ², 0.160; P =.690) or treatment-by-time interactions (χ², 0.096; P =.757) observed.

Similarly, there were no treatment-by-time interactions in mean arterial blood pressure (χ², 0.006; P =.937) or total cholesterol (χ², 0.319; P =.572).

Overall, both the infliximab and placebo recipients were categorized as having low 10-year CVD risk (FRS <10%).

This study may have been biased, as previous research has indicated that the BD population is associated with increased CVD burden, however, this population was considered to be at a low CVD risk.

The study authors concluded, “There were no changes in FRS, mean arterial blood pressure or total cholesterol detected in infliximab-treated participants relative to the placebo-randomized group. However, there remains an unmet need to further investigate the CVD-BD link. To our knowledge, this is the first study to evaluate the efficacy of the anti-inflammatory agent, infliximab, on CVD risk in individuals with BD. CVD is the leading cause of mortality in people with BD.”

Disclosure: Multiple authors declared affiliations with industry. Please refer to the original article for a full list of disclosures.

Reference

Gill H, Rodrigues NB, Mansur RB, et al. The effect of adjunctive infliximab treatment on future cardiovascular disease risk in patients with bipolar disorder. J Affect Disord. 2022;S0165-0327(22)00788-1. doi:10.1016/j.jad.2022.07.020

This article originally appeared on Psychiatry Advisor