• Citer

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

par Esters, Nele;Vermeire, Séverine;Joossens, Sofie;Noman, Maja;Louis, Edouard;Belaiche, Jacques;De Vos, Martine;Van Gossum, André ;Pescatore, Paul;Fiasse, René;Pelckmans, Paul;Reynaert, Hendrik;Poulain, Daniel;Bossuyt, Xavier;Rutgeerts, Paul
Référence The American journal of gastroenterology, 97, 6, page (1458-1462)
Publication Publié, 2002

Article révisé par les pairs

• Détails
• Contenu

Résumé :

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. © 2002 by Am. Coll. of Gastroenterology.