Anti-Tumor Necrosis Factor Drug Response in Chronic Inflammatory Bowel Disease and Influencing Factors

Aims Investigating the predictive factors of good response to anti-TNF agents in patients with inflammatory bowel disease (IBD).

Methods A prospective single center study was conducted, including consecutive IBD patients with more than 6 months of follow up on anti-TNF (Infliximab (IFX) or Adalimumab (ADM)) (July 2019-december 2019). Data about patient’s demographic characteristics, IBD’s features, IFX and ADM serum concentration, Serum concentration of anti-drug antibodies (ADAs) against IFX and ADM as well as response to anti-TNF agents were collected. The response was assessed by clinical and endoscopic scores for each disease: Best’s index for Crohn disease (CD) and endoscopic Mayo score for ulcerative colitis (UC).

Results Forty-one patients with IBD were included (35 CD (86 %) and 6 UC (14 %)) (median age: 27 y. (8-49 y.); 23 males). Mean duration of IBD was 10 y. (1-24 y.). Biotherapy had been prescribed after a median delay of 34 mo. (8-96 mo.) from the date of diagnosis of the IBD. Thirty three patients (80 %) were taking an immunomodulator drug. Twenty six patients (63 %) were responders to anti-TNF agents. The response was significantly better in case of absence of family history of IBD (p <0.001), negative ADAs (p < 0.001), absence of a switch (p = 0.014), IFX serum concentration ≥ 1.09 mg/l (p < 0.001), ADM serum concentration ≥ 4.17 mg/l (p > 0.001) and serum C-reactive protein (CRP) < 8 mg/l (P < 0.001). Multivariate analysis revealed that negative CRP associated with anti-TNF serum concentration within therapeutic range (component > 0.5) and negative ADAs associated with absence of a switch (component > 0.5) were independent predictors of good response.

Conclusions The association between negative CRP and anti-TNF serum concentration within therapeutic range, as well as negative ADAs with absence of switch were independent predictors of good response to anti-TNF agents.

Citation: Laabidi S, Bizid S, Ben Mahmoud A etal. eP257 ANTI-TUMOR NECROSIS FACTOR DRUG RESPONSE IN CHRONIC INFLAMMATORY BOWEL DISEASE AND INFLUENCING FACTORS. Endoscopy 2021; 53: S182.

Publication History

Article published online:
19 March 2021