Serological markers for prediction of response to anti-tumor necrosis factor treatment in Crohn's disease.
(2002) The American journal of gastroenterology — Vol. 97, n° 6, p. 1458-1462 (2002)
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- The use of monoclonal anti-tumor necrosis factor (TNF) antibodies (infliximab, Remicade) is a new therapeutic approach for severe refractory luminal or fistulizing, Crohn's disease (CD). However, up to 30% of patients do not respond to this treatment. So far, no parameters predictive of response to anti-TNF have been identified. Our aim was to determine whether serological markers ASCA (anti-Saccharomyces cerevisiae antibodies) or pANCA (perinuclear antineutrophil cytoplasmic antibodies) could identify Crohn's patients likely to benefit from anti-TNF therapy. Serum samples of 279 CD patients were analyzed for ASCA and pANCA before anti-TNF therapy. A blinded physician determined clinical response at week 4 (refractory luminal CD) or week 10 (fistulizing CD) after the first infusion of infliximab (5 mg/kg). Overall, there was no relationship between ASCA or pANCA and response to therapy. However, lower response rates were observed for patients with refractory intestinal disease carrying the pANCA+/ASCA- combination, although this lacked significance (p = 0.067). In this cohort of infliximab-treated patients, neither ASCA nor pANCA could predict response to treatment. However, the combination pANCA+/ASCA- might warrant further investigation for its value in predicting nonresponse in patients with refractory luminal disease.
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Esters, N., Vermeire, S., Joossens, S., Noman, M., Louis, E., Belaiche, J., De Vos, M., Van Gossum, A., Pescatore, P., Fiasse, R., Pelckmans, P., Reynaert, H., Poulain, D., Bossuyt, X., & Rutgeerts, P. (2002). Serological markers for prediction of response to anti-tumor necrosis factor treatment in Crohn’s disease. The American journal of gastroenterology, 97(6), 1458-1462. https://doi.org/10.1111/j.1572-0241.2002.05689.x (Original work published 2002)