Analysis of the factors related to anti-TNF alpha response in the treatment of Crohn's Disease

Abstract

Crohn's disease (CD) presents a great challenge regarding treatment, considering that the best drugs available have very limited effectiveness.

Objective To analyze the characteristics between groups of patients with Crohn's disease who had response versus had not/lost response to treatment with anti-TNF.

Method Retrospective study of patients with CD treated with IFX or ADA.

Results We studied 72 patients with mean age of 35 years; 45 of them were treated with infliximab and 27 with adalimumab; 90% of women were respondents, compared to 10% who were not respondents/lost response, and 60% of men were respondents versus 40% who were not respondents/lost response; there was no difference between IFX and ADA with respect to response; 48 patients were < 40 and 24 > 40 years old. Of those who had < 40 years, 37 were respondents, compared to 11 who were not respondents/lost response. Of those with > 40 years, 16 were respondents versus 8 who were not respondents/lost response; patients under 2 years of diagnosis had a better response than those with two to five years of symptoms, and these latter exhibited a better response than those with more than five years of diagnosis.

Conclusion The observed characteristics of response to treatment of CD with anti-TNF were: association to azathioprine, female gender, age < 40 years and less than two years of diagnosis.

Resumo

A doença de Crohn (DC) apresenta um grande desafio quanto ao seu tratamento, considerando-se que os melhores medicamentos disponíveis têm eficácia bastante limitada.

Objetivo Analisar as características entre os grupos de pacientes com DC que responderam e os que não responderam ou perderam a resposta ao tratamento com anti-TNF. Método: Estudo retrospectivo de pacientes com DC que fizeram uso de IFX ou ADA.

Resultados Foram estudados 72 pacientes com média de idade de 35 anos; 45 foram tratados com adalimumabe e 27 com infliximabe; 90% das mulheres tiveram resposta, contra 10 que não tiveram/perderam resposta; dos homens, 60% tiveram resposta contra 40% que não tiveram/perderam resposta; não houve diferença entre IFX e ADA quanto à resposta; 48 tinham menos de 40 anos e 24 mais de 40 anos. Dos com < 40 anos, 37 tiveram resposta, contra 11 que não tiveram/perderam resposta. Daqueles com > 40 anos, 16 tiveram resposta contra 8 que não tiveram/perderam resposta; pacientes com menos de 2 anos de diagnóstico tiveram melhor resposta do que aqueles com dois a cinco anos de sintomas; e estes tiveram melhor resposta que aqueles com mais de cinco anos de diagnóstico.

Conclusão As características observadas de melhor resposta ao tratamento da DC com anti-TNF foram associação com azatioprina, gênero feminino, idade menor de 40 anos e menos de dois anos de diagnóstico.

Keywords

Crohn's disease - Infliximab - Adalimumab - Treatment - Age Gender

Palavras-chave

Doença de Crohn - Infliximabe - Adalimumabe - Tratamento - Idade - Gênero

Publication History

Received: 13 October 2013

Accepted: 23 December 2013

Article published online:
17 February 2021