Optimizing the use of anti-tumor necrosis factor in the management of patients with Crohn’s disease

Nguyen, Douglas L.; Flores, Sarah; Sassi, Kareem; Bechtold, Matthew L.; Nguyen, Emily; Parekh, Nimisha K.

doi:10.1177/2040622315579621

Cited by 15 publications

(15 citation statements)

References 49 publications

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“…The results of our study indicated that half-ED could be effective in improving the long-term prognosis of CD patients treated with anti-TNF-α antibodies, by extending the cumulative retention efficacy of the treatments. Indeed, several retrospective studies from Japanese institutions have reported that the patients, who were treated with IFX and a concomitant elemental diet, exhibited better long-term outcomes than those who were treated with IFX alone [29-33]. The present study strongly supports this previous evidence of the increase in IFX efficacy.…”

Section: Discussionsupporting

confidence: 88%

Long-term prognosis of Japanese patients with biologic-naïve Crohn’s disease treated with anti-tumor necrosis factor-α antibodies

et al. 2019

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Background/AimsFew reports have described the long-term treatment outcomes of the anti-tumor necrosis factor-α antibody for Japanese Crohn’s disease (CD) patients. The aim of this study was to evaluate them and clarify the clinical factors that affect the long-term prognosis of the anti-tumor necrosis factor-α treatments.MethodsThis was a retrospective, observational, single-center cohort study. Japanese CD patients treated with either infliximab or adalimumab as a first-line therapy were analyzed. The cumulative retention rates of the biologics, relapse-free survival, and surgery-free survival were analyzed using Kaplan-Meier methods. The clinical factors associated with the long-term outcomes were estimated by both the log-rank test and Cox proportional hazard model.ResultsThe cumulative retention rate was significantly higher in the group with a concomitant elemental diet of ≥900 kcal/day, baseline C-reactive protein (CRP) levels <2.6 mg/dL, and baseline serum albumin levels ≥3.5 g/dL, respectively. The baseline serum albumin levels were also associated with both relapse-free and surgery-free survival. The lack of concomitant use of an elemental diet ≥900 kcal/day was identified as the only independent risk factor for the withdrawal of the biologics.ConclusionsBaseline CRP levels and serum albumin levels could affect the long-term outcomes in CD patients. Concomitant elemental diet of ≥900 kcal/day could have a positive influence on clinical treatment course.

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Section: Discussionsupporting

confidence: 88%

Long-term prognosis of Japanese patients with biologic-naïve Crohn’s disease treated with anti-tumor necrosis factor-α antibodies

et al. 2019

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“…The majority of clinically approved antibody drugs are antagonists that block specific receptors, such as the case for HER-2/EGF receptors ( 39 , 40 ), or sequester specific proteins, as in the case of anti-TNF or anti-VEGF antibodies ( 41 , 42 ). Conversely, among the vast chemical diversity represented by the human antibody repertoire, it is possible to identify antibodies that activate cell-surface receptors or ion channels.…”

Section: Discussionmentioning

confidence: 99%

Fully human agonist antibodies to TrkB using autocrine cell-based selection from a combinatorial antibody library

Merkouris

Barde

Binley

et al. 2018

Proc. Natl. Acad. Sci. U.S.A.

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SignificanceNeurotrophin receptors are a class of receptor tyrosine kinases that couple to signaling pathways critical for neuronal survival and growth. One member, TrkB, is particularly interesting because it plays a role in many severe degenerative neurological diseases. The TrkB natural ligand brain-derived neurotrophic factor (BDNF) is not suitable to be developed as a drug or therapy as proved by previous unsuccessful clinical trials. Here we report a selection method that produced potent full agonist antibodies that mimic BDNF function, yet with better biophysical properties. This study paves the road for the development of agonist antibodies for other receptor tyrosine kinases.

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“…However, it should be acknowledged that our study sample might have included patients who did not receive optimal anti-TNF dosing [ 35 , 36 ]. As previous studies have shown, in fact, only an anti-TNF concentration >3 μg/mL is associated with clinical response and lower disease activity [ 37 ]. Furthermore, multiple factors might affect the pharmacokinetics of anti-TNF levels, including albumin, weight, gender, inflammation, administration route, and immunogenicity [ 37 ].…”

Section: Discussionmentioning

confidence: 99%

“…As previous studies have shown, in fact, only an anti-TNF concentration >3 μg/mL is associated with clinical response and lower disease activity [ 37 ]. Furthermore, multiple factors might affect the pharmacokinetics of anti-TNF levels, including albumin, weight, gender, inflammation, administration route, and immunogenicity [ 37 ]. Notwithstanding the multiplicity of factors that might influence response to biologic therapy, no single marker has been identified so far as a reliable predictor of response or suboptimal therapy in UC and CD [ 38 , 39 ].…”

Section: Discussionmentioning

confidence: 99%

Indicators of suboptimal biologic therapy over time in patients with ulcerative colitis and Crohn's disease in the United States

Patel¹,

Lissoos

Rubin

2017

PLoS ONE

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This study assessed the occurrence of indicators for suboptimal biologic therapy among ulcerative colitis (UC) and Crohn’s disease (CD) patients over time in the United States (US). Data from a large US claims database (2005–2013) were used to retrospectively identify patients with diagnosed with either UC or CD who were new biologic users. Indicators of suboptimal biologic therapy included: dose escalation during the maintenance phase, discontinuation of the initial biologic, switch to another biologic within 90 days following the last day of supply of the initial biologic, augmentation with a non-biologic systemic therapy, UC- or CD-related surgery, UC- or CD-related urgent care, and development of fistula (for CD only). Kaplan-Meier analyses were used. A total of 1,699 UC and 4,569 CD patients were included. Among UC patients, 51.1% and 90.9% experienced ≥1 indicator of suboptimal biologic therapy within 6 months and 36 months of biologic therapy initiation, respectively. Among CD patients, 54.3% and 91.4% experienced ≥1 indicator of suboptimal biologic therapy within 6 and 36 months of biologic therapy initiation, respectively. For both UC and CD patients, the most frequent indicators of suboptimal biologic therapy were discontinuation, dose escalation and augmentation. In conclusion, this study found that the occurrence of suboptimal biologic therapy is common among patients with UC and CD, with approximately 90% of patients experiencing at least one indicator of suboptimal biologic therapy within 36 months of biologic treatment initiation.

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Optimizing the use of anti-tumor necrosis factor in the management of patients with Crohn’s disease

Cited by 15 publications

References 49 publications

Long-term prognosis of Japanese patients with biologic-naïve Crohn’s disease treated with anti-tumor necrosis factor-α antibodies

Long-term prognosis of Japanese patients with biologic-naïve Crohn’s disease treated with anti-tumor necrosis factor-α antibodies

Fully human agonist antibodies to TrkB using autocrine cell-based selection from a combinatorial antibody library

Indicators of suboptimal biologic therapy over time in patients with ulcerative colitis and Crohn's disease in the United States

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