Impact of comorbidities on anti-TNFα response and relapse in patients with inflammatory bowel disease : The VERNE study
Marín-Jiménez, Ignacio (Hospital General Universitario Gregorio Marañón)
Bastida, Guillermo (Hospital Universitari i Politècnic La Fe (València))
Forés, Ana (Consorci Hospitalari Provincial de Castelló)
García-Planella, Esther (Institut d'Investigació Biomèdica Sant Pau)
Argüelles-Arias, Federico (Hospital Universitario Virgen Macarena (Sevilla, Andalusia))
Sarasa, Pilar (Takeda Farmacéutica España SA)
Tagarro, Ignacio (Takeda Farmacéutica España SA)
Fernández-Nistal, Alonso (Takeda Farmacéutica España SA)
Montoto, Carmen (Takeda Farmacéutica España SA)
Aguas, Mariam (Hospital Universitari i Politècnic La Fe (València))
Santos-Fernandez, Javier (Hospital Universitario Río Hortega (Valladolid))
Bosca-Watts, Marta Maia (Hospital Clínic Universitari (València))
Ferreiro, Rocio (Hospital Clínico Universitario (Santiago de Compostela, Galícia))
Merino, Olga (Hospital Universitario de Cruces (Barakaldo, País Basc))
Aldeguer, Xavier (Hospital Universitari de Girona Doctor Josep Trueta)
Cortés Rizo, Xavier (Hospital de Sagunto)
Sicilia Aladrén, Beatriz (Hospital Universitario de Burgos)
Mesonero, Francisco (Hospital Universitario Ramón y Cajal (Madrid))
Barreiro de-Acosta, Manuel (Hospital Clínico Universitario (Santiago de Compostela, Galícia))
Universitat Autònoma de Barcelona

Fecha:	2020
Resumen:	To evaluate the impact of comorbidities and extraintestinal manifestations of inflammatory bowel disease on the response of patients with inflammatory bowel disease to antitumour necrosis factor alpha (anti-TNFα) therapy. Data from 310 patients (194 with Crohn's disease and 116 with ulcerative colitis) treated consecutively with the first anti-TNFα in 24 Spanish hospitals were retrospectively analysed. Univariate and multivariate logistic regression analyses were performed to assess the associations between inflammatory bowel disease comorbidities and extraintestinal manifestations with anti-TNFα treatment outcomes. Key clinical features, such as type of inflammatory bowel disease and concomitant treatments, were included as fixed factors in the model. Multivariate logistic regression analyses (OR, 95% CI) showed that chronic obstructive pulmonary disease (2. 67, 1. 33 to 5. 35) and hepato-pancreato-biliary diseases (1. 87, 1. 48 to 2. 36) were significantly associated with primary non-response to anti-TNFα, as was the use of corticosteroids and the type of inflammatory bowel disease (ulcerative colitis vs Crohn's disease). It was also found that myocardial infarction (3. 30, 1. 48 to 7. 35) and skin disease (2. 73, 1. 42 to 5. 25) were significantly associated with loss of response, along with the use of corticosteroids and the type of inflammatory bowel disease (ulcerative colitis vs Crohn's disease). Our results suggest that the presence of some comorbidities in patients with inflammatory bowel disease, such as chronic obstructive pulmonary disease and myocardial infarction, and of certain extraintestinal manifestations of inflammatory bowel disease, such as hepato-pancreato-biliary conditions and skin diseases, appear to be related to failure to anti-TNFα treatment. Therefore, their presence should be considered when choosing a treatment.
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	Crohn's disease ; Immune response ; TNF-alpha ; Ulcerative colitis
Publicado en:	BMJ Open Gastroenterology, Vol. 7 Núm. 1 (26 2020) , p. e000351, ISSN 2054-4774

DOI: 10.1136/bmjgast-2019-000351
PMID: 32337054

10 p, 377.8 KB

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