Year 2020 / Volume 112 / Number 8
Original
Predictive factors of clinical response to treatment with anti-TNF agents in ulcerative colitis: what have we learned from our patients?

636-641

DOI: 10.17235/reed.2020.6688/2019

Laura Ramos, Alejandro Hernández Camba, Raquel de la Barreda Heusser, Milagros Vela, Inmaculada Alonso-Abreu, Esther Rodríguez G., Marta Carrillo, Carlos Tardillo, Yolanda Rodríguez, Andrés Figueroa Marrero, Daniel Ceballos, Noelia Cruz, Lilian Kolle-Casso, Alejandro Jiménez Sosa,

Abstract
Introduction: inhibitors of tumor necrosis factor alpha (anti-TNFs) are effective drugs for the treatment of moderate-to-severe ulcerative colitis (UC). However, many patients do not respond or lose therapeutic response during follow-up. Objectives: to analyze the determining factors of clinical response to anti-TNFs in UC. Methods: a multicenter retrospective study was performed in 79 patients with UC who started treatment with anti-TNFs between 2009 and 2015. The primary endpoint was clinical remission (pMayo index ≤ 1) at 12 months. Furthermore, remission and clinical response (final pMayo score ≤ 3) and corticoids discontinuation were assessed at three, six and 12 months. An analysis was performed to identify variables predictive of clinical response. Results: at 12 months, remission and clinical response were seen in 59.2 % and 77.8 % of patients, respectively. Corticoids could be discontinued in 82.4 % of patients. At 12 months, corticoids discontinuation (< 3 months) (OR 0.06; 95 % CI: 0.01-0.24) and clinical response at six months (OR 0.008; 95 % CI: 0.001-0.053) were independent factors predictive of clinical remission. Conclusion: in patients with active UC on anti-TNFs, corticoid discontinuation within three months and clinical response at six months after treatment onset are predictive of clinical disease remission.
Share Button
New comment
Comments
No comments for this article
References
1. Ungaro R, Mehandru S, Allen PB, et al.Ulcerative colitis. Lancet. 2017;389:70---1756.2.
2. Molodecky NA, Soon IS, Rabi DM, et al. Increasing incidence and prevalence of the inflam-matory bowel diseases with time, based on systematic review.Gastroenterology. 2012;142:46-54, e42.
3. Marín-Jiménez I, Saro C, Díaz V, et al. Epidemiology and hospital resources use in the treatment of ulcerative colitis at gastroenterology units in Spain (EPICURE study). Drugs Context. 2018 Mar 6;7:212505
4. Solberg IC, Lygren I, Jahnsen J, et al. Clinical course during the first 10 yearsof ulcerative colitis: results from a population-based inceptioncohort (IBSEN Study). Scand J Gastroenterol 2009;44:431–40.
5. Gisbert JP, Chaparro M. Acute severe ulcerative colitis: State of the art treatment. Best Pract Res Clin Gastroenterol 2018;33:59-69.
6. Kolehmainen S, Lepistö A, Färkkilä M. Impact of anti-TNF-alpha therapy on colectomy rate and indications for colectomy in ulcerative colitis: comparison of two patient cohorts from 2005 to 2007 and from 2014 to 2016. Scand J Gastroenterol. 2019 May 28:1-5.
7. Danese S, Colombel JF, Peyrin-Biroulet L, et al. Review article: the role of anti-TNF in the management of ulcerative colitis -- past, present and future. Aliment Pharmacol Ther. 2013 May;37(9):855-66
8. Bonovas S, Lytras T, Nikolopoulos G, et al. Systematic review with network meta-analysis: comparative assessment of tofacitinib and biological therapies for moderate-to-severe ulcerative colitis. Aliment Pharmacol Ther. 2018 Feb;47(4):454-465.
9. Rutgeerts P, Sandborn WJ, Feagan BG, et al. Infliximab for induction and maintenance therapy for ulcerative colitis. N Engl J Med 2005; 353: 2462–76
10. Sandborn WJ, van Assche G, Reinisch W, et al. Adalimumab induces and maintains clinical remission in patients with moderate-to-severe ulcerative colitis. Gastroenterology 2012; 142: 257–65.
11. Paschos P, Katsoula A, Salanti G, et al. Systematic review with network meta-analysis: The impact of medical interventions for moderate-to-severe ulcerative colitis on health-related quality of life. Aliment Pharmacol Ther 2018; Dec; 48(11-12):1174-1185.
12. Ferrante M, Vermeire S, Fidder H, et al. Long-term outcome after infliximab for refractory ulcerative colitis. J Crohn’s Colitis 2008; 2: 219–25
13. Oussalah A, Evesque L, Laharie D, et al. A multicenter experience with infliximab for ulcerative colitis: outcomes and predictors of response, optimization, colectomy, and hospitalization. Am J Gastroenterology 2010; 105: 2617–25.
14. Armuzzi A, Pugliese D, Danese S, et al. Infliximab in steroid-dependent ulcerative colitis: effectiveness and predictors of clinical and endoscopic remission. Inflamm Bowel Dis 2013 Apr;19(5):1065-72.
15. Seow CH, Newman A, Irwin SP, et al. Trough serum infliximab: a predictive factor of clinical outcome for infliximab treatment in acute ulcerative colitis. Gut 2010; 59: 49–54.
16. D’Haens GR, Panaccione R, Higgins PD, et al. The London Position Statement of the World Congress of Gastroenterology on Biological Therapy for IBD with the European Crohn’s and Colitis Organization: when to start, when to stop, which drug to choose, and how to predict response? Am J Gastroenterol 2011; 106: 199–212.
17. Garcia-Planella E, et al Long-term outcome of ulcerative colitis in patients who achieve clinical remission with a first course of corticosteroids. Dig Liver Dis. 2012 Mar;44(3):206-10.
18. Gisbert JP, Marin AC, McNicholl AG, et al. Systematicreview with meta-analysis: the efficacy of a second anti-TNFin patients with inflammatory bowel disease whose pre-vious anti-TNF treatment has failed. Aliment Pharmacol Ther.2015;41:23---613.
19. Gisbert JP, Panes J. Loss of response and requirement of infli-ximab dose intensification in Crohn’s disease: a review. Am JGastroenterol. 2009;104:7---760.
20. Domenech E, Gisbert JP. Efficacy and safety of vedolizumabin the treatment of ulcerative colitis. Gastroenterol Hepatol.2016;39:86---677.26.
21. Sandborn WJ, Su C, Sands BE, et al. Tofacitinib as induction and maintenance therapy forulcerative colitis. N Engl J Med. 2017;376:36---1723.23.
Related articles

Letter

Tofacitinib-induced eosinophilia

DOI: 10.17235/reed.2023.9831/2023

Letter

Hepatosplenic T-cell lymphoma and inflammatory bowel disease

DOI: 10.17235/reed.2023.9472/2023

Letter

Perianal Paget’s disease

DOI: 10.17235/reed.2022.9304/2022

Letter

Chinese dragon sign of ulcerative colitis

DOI: 10.17235/reed.2022.9154/2022

Letter

Ulcerative colitis exacerbated by strongyloidiasis

DOI: 10.17235/reed.2022.9044/2022

Review

Clinical settings with tofacitinib in ulcerative colitis

DOI: 10.17235/reed.2022.8660/2022

Letter

Mesalazine induced interstitial pneumonitis in the COVID era

DOI: 10.17235/reed.2022.8635/2021

Letter

The effect of Adacolumn® on ulcerative colitis with COVID-19

DOI: 10.17235/reed.2020.7156/2020

Letter

Sweet syndrome in severe ulcerative flare

DOI: 10.17235/reed.2020.6995/2020

Original

Megacolon in inflammatory bowel disease: response to infliximab

DOI: 10.17235/reed.2020.6394/2019

Letter to the Editor

Ulcerative colitis with gastric and duodenal involvement

DOI: 10.17235/reed.2017.4685/2016

Editorial

Specialist care in the management of inflammatory bowel disease

DOI: 10.17235/reed.2016.4628/2016

Original

Mercaptopurine and inflammatory bowel disease: the other thiopurine

DOI: 10.17235/reed.2016.4546/2016

Case Report

Mesalamine-induced myopericarditis - A case report

DOI: 10.17235/reed.2016.4016/2015

Citation tools
Ramos L, Hernández Camba A, de la Barreda Heusser R, Vela M, Alonso-Abreu I, Rodríguez G. E, et all. Predictive factors of clinical response to treatment with anti-TNF agents in ulcerative colitis: what have we learned from our patients?. 6688/2019


Download to a citation manager

Download the citation for this article by clicking on one of the following citation managers:

Metrics
This article has received 1773 visits.
This article has been downloaded 207 times.

Statistics from Dimensions


Statistics from Plum Analytics

Publication history

Received: 16/10/2019

Accepted: 09/01/2020

Online First: 24/06/2020

Published: 30/07/2020

Article revision time: 73 days

Article Online First time: 252 days

Article editing time: 288 days


Share
This article hasn't been rated yet.
Reader rating:
Valora este artículo:




Asociación Española de Ecografía Digestiva Sociedad Española de Endoscopia Digestiva Sociedad Española de Patología Digestiva
The Spanish Journal of Gastroenterology is the official organ of the Sociedad Española de Patología Digestiva, the Sociedad Española de Endoscopia Digestiva and the Asociación Española de Ecografía Digestiva
Cookie policy Privacy Policy Legal Notice © Copyright 2023 y Creative Commons. The Spanish Journal of Gastroenterology