Serological markers for prediction of response to anti-tumor necrosis factor treatment in Crohn's disease.

Abstract

OBJECTIVES:

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.

METHODS:

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).

RESULTS:

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).

CONCLUSIONS:

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.

• Authors: N Esters, S Vermeire, S Joossens, M Noman, E Louis, J Belaiche, M De Vos, A Van Gossum, P Pescatore, R Fiasse, P Pelckmans, H Reynaert, D Poulain, X Bossuyt, P Rutgeerts, Belgian Group of Infliximab Expanded Access Program in Crohn's Disease
• Journal: The American journal of gastroenterology (Am J Gastroenterol) Vol. 97 Issue 6 Pg. 1458-62 (Jun 2002) ISSN: 0002-9270 [Print] United States
• PMID: 12094865 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Antibodies, Antineutrophil Cytoplasmic
• Antibodies, Fungal
• Antibodies, Monoclonal
• Gastrointestinal Agents
• Infliximab

Topics

• Adolescent
• Adult
• Aged
• Antibodies, Antineutrophil Cytoplasmic (analysis)
• Antibodies, Fungal (analysis)
• Antibodies, Monoclonal (therapeutic use)
• Cohort Studies
• Crohn Disease (drug therapy, immunology)
• Forecasting
• Gastrointestinal Agents (therapeutic use)
• Humans
• Infliximab
• Middle Aged
• Saccharomyces cerevisiae (immunology)
• Single-Blind Method
• Treatment Outcome