BMI is important in predicting the loss of response in inflammatory bowel disease patients on tumour necrosis factor-α inhibitors

Chuck, Winnie; Shadbolt, Bruce Frederick; Nordin, Fariza Juliana; Subramaniam, Kavitha

doi:10.1097/meg.0000000000002371

Cited by 8 publications

(2 citation statements)

References 41 publications

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“…Another study also reported that IBD patients with a high BMI displayed a high rate of LOR[ 118 ]. In IBD patients treated with adalimumab, SNR was increased in those with BMI ≥ 30 kg/m 2 compared with those with BMI < 30 kg/m 2 [ 119 ].…”

Section: Predictors Of Secondary Nonresponsementioning

confidence: 99%

“…Serum albumin: In CD patients treated with certolizumab, low albumin predicted SNR[ 28 ]. Higher albumin levels were associated with lower LOR in IBD patients treated with infliximab[ 119 ]. A prospective study found that IBD patients with low albumin serum concentrations at baseline had a significantly increased risk for SNR to anti-TNF and that normalization of albumin levels during treatment did not reduce this risk[ 120 ].…”

Section: Predictors Of Secondary Nonresponsementioning

confidence: 99%

See 1 more Smart Citation

Predictors and optimal management of tumor necrosis factor antagonist nonresponse in inflammatory bowel disease: A literature review

Wang¹,

Chen²,

He³

et al. 2023

World J Gastroenterol

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Tumor necrosis factor-α (TNF-α) antagonists, the first biologics approved for treating patients with inflammatory bowel disease (IBD), are effective for the induction and maintenance of remission and significantly improving prognosis. However, up to one-third of treated patients show primary nonresponse (PNR) to anti-TNF-α therapies, and 23%-50% of IBD patients experience loss of response (LOR) to these biologics during subsequent treatment. There is still no recognized predictor for evaluating the efficacy of anti-TNF drugs. This review summarizes the existing predictors of PNR and LOR to anti-TNF in IBD patients. Most predictors remain controversial, and only previous surgical history, disease manifestations, drug concentrations, antidrug antibodies, serum albumin, some biologic markers, and some genetic markers may be potentially predictive. In addition, we also discuss the next steps of treatment for patients with PNR or LOR to TNF antagonists. Therapeutic drug monitoring plays an important role in treatment selection. Dose escalation, combination therapy, switching to a different anti-TNF drug, or switching to a biologic with a different mechanism of action can be selected based on the concentration of the drug and/or antidrug antibodies.

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Section: Predictors Of Secondary Nonresponsementioning

confidence: 99%