Predictive Factors for Loss of Response to Anti-TNF in Crohn’s Disease

Santos, B.R.M. dos; Santos, Carlos Henrique Marques dos; Santos, Vitória Rossetti Moreira Dos; Torrez, Claudia Yanina Garcia; Palomares-Junior, Daniel

doi:10.1590/0102-672020200002e1522

Cited by 3 publications

(4 citation statements)

References 17 publications

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“…A retrospective study on CD patients showed that anemia is a predictive factor for loss of response to anti-TNF [198]; moreover, anemic CD patients had two-times greater odds ratio of severe hospitalization compared with non-anemic patients (OR 1.49, 95% CI: 1.37-1.61) [168].…”

Section: Clinical Disease Course and Response To Therapiesmentioning

confidence: 99%

Nutrition, Nutritional Status, Micronutrients Deficiency, and Disease Course of Inflammatory Bowel Disease

Valvano,

Capannolo,

Cesaro

et al. 2023

Nutrients

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During the disease course, most Inflammatory Bowel Disease patients present a condition of malnutrition, undernutrition, or even overnutrition. These conditions are mainly due to suboptimal nutritional intake, alterations in nutrient requirements and metabolism, malabsorption, and excessive gastrointestinal losses. A suboptimal nutritional status and low micronutrient serum levels can have a negative impact on both induction and maintenance of remission and on the quality of life of Inflammatory Bowel Disease patients. We performed a systematic review including all the studies evaluating the connection between nutrition, nutrition status (including undernutrition and overnutrition), micronutrient deficiency, and both disease course and therapeutic response in Inflammatory Bowel Disease patients. This systematic review was performed using PubMed/MEDLINE and Scopus. Four main clinical settings concerning the effect of nutrition on disease course in adult Inflammatory Bowel Disease patients were analyzed (induction of remission, maintenance of remission, risk of surgery, post-operative recurrence, and surgery-related complications). Four authors independently reviewed abstracts and manuscripts for eligibility. 6077 articles were found; 762 duplicated studies were removed. Out of 412 full texts analyzed, 227 were included in the review. The evidence summarized in this review showed that many nutritional aspects could be potential targets to induce a better control of symptoms, a deeper remission, and overall improve the quality of life of Inflammatory Bowel Disease patients.

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Section: Clinical Disease Course and Response To Therapiesmentioning

confidence: 99%

Nutrition, Nutritional Status, Micronutrients Deficiency, and Disease Course of Inflammatory Bowel Disease

Valvano,

Capannolo,

Cesaro

et al. 2023

Nutrients

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“…O infliximabe reduziu o processo inflamatório mucoso e a infiltração de células inflamatórias na mucosa e submucosa do cólon excluso 3 . Quando se considera que a terapia biológica, em especial com infliximabe é considerada a opção terapêutica mais eficiente para o tratamento das DII 27 . Sendo assim, é possível que seu uso na CD possa, da mesma forma, reduzir a inflamação e preservar os sistemas de defesa epitelial.…”

Section: Mensagem Centralunclassified

“…Infliximab reduced the mucosal inflammatory process and the infiltration of inflammatory cells in the excluded colonic mucosa and submucosa 3 . By reducing the inflammatory process and favoring the healing of the mucosa, biological therapy, especially infliximab, is considered the most effective therapeutic option for the treatment of IBD 27 . Thus, it is possible that its use in DC can, in the same way, reduce inflammation and preserve epithelial defense systems.…”

Section: Introductionmentioning

confidence: 99%

Expressão De E-Caderina E Claudina-3 No Epitélio Cólico Após Terapia Com Infliximabe: Modelo Experimental De Colite De Exclusão

Junior

Goto

Pereira

et al. 2021

ABCD, arq. bras. cir. dig.

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RESUMO - RACIONAL: A etiopatogenia da colite por desuso (DC) ainda não foi totalmente elucidada. As principais teorias consideram que a doença pode estar relacionada ao aumento de bactérias anaeróbias, falta de suprimento de ácidos graxos de cadeia curta (AGCC) e distúrbios imunológicos que se desenvolvem em segmentos colorretais desprovidos de trânsito fecal. OBJETIVO: Verificar se a aplicação de infliximabe modifica o conteúdo tecidual das proteínas E-caderina e claudina-3 no epitélio cólico de ratos sem trânsito intestinal. MÉTODOS: Vinte dois ratos foram submetidos a derivação do trânsito intestinal pelo procedimento de Hartmann. Eles permaneceram com o ostoma por 12 semanas para permitir o desenvolvimento da colite de exclusão. Em seguida, foram divididos em três grupos experimentais: seis animais receberam 2,0 ml de solução salina/semana, oito infliximabe na dose de 5 mg/Kg/semana e, os demais, infliximabe na dose de 10 mg/Kg/semana por 5 semanas consecutivas. Em seguida, os animais foram eutanasiados e os segmentos cólicos com e sem trânsito intestinal foram removidos. A colite por desuso foi diagnosticada pelas alterações histológicas definidas por uma escala previamente validada. Expressão tecidual de E-caderina e claudina-3 foi avaliada por imuno-histoquímica, e o conteúdo tecidual de ambas as proteínas foi quantificado por análise de imagem assistida por computador. RESULTADOS: Segmentos cólicos exclusos de trânsito fecal apresentaram maior grau de inflamação do que os expostos ao trânsito fecal. Inflamação foi menor nos animais tratados com infliximabe, independente da dose utilizada. Níveis de E-caderina e claudina-3 estavam reduzidos no cólon excluso. O tratamento com infliximabe aumentou os níveis das proteínas em segmentos do cólon sem trânsito intestinal, principalmente nos animais que receberam a dose de 10mg/kg/semana. CONCLUSÃO: Infliximabe reduz inflamação nos segmentos do cólon excluso e aumenta o conteúdo tecidual de E-caderina e claudina-3, especialmente na concentração de 10mg/kg/semana.

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“…The ileal disease is associated with CD phenotypes involving stricture and obstruction that result in a more complicated disease and an increased need for surgery 14 . In recent decades, developments in drug therapy have significantly postponed the need for surgery 22 . Nevertheless, most of the patients with CD still require one or more surgical interventions during their disease.…”

Section: Introductionmentioning

confidence: 99%

Assessment of Risk Factors for Surgery Treatment of Crohn’s Disease: A Hospital Cohort

TAJRA,

CALEGARO,

SILVA

et al. 2023

ABCD, arq. bras. cir. dig.

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BACKGROUND New therapies have revolutionized the treatment of Crohn’s disease (CD), but in some countries, the surgery rate has not changed, the frequency of emergency surgery is underestimated, and surgical risk is poorly studied. AIMS: The aim of this study was to identify risk factors and clinical indications for primary surgery in CD patients at the tertiary hospital. METHODS: This was a retrospective cohort of a prospectively collected database of 107 patients with CD from 2015 to 2021. The main outcomes were the incidence of surgery treatment, types of procedures performed, surgical recurrence, surgery free time, and risk factors for surgery. RESULTS: Surgical intervention was performed in 54.2% of the patients, and most of the procedures were emergency surgeries (68.9%). The elective procedures (31.1%) were performed over 11 years after diagnosis. The main indications for surgery were ileal stricture (34.5%) and anorectal fistulas (20.7%). The most frequent procedure was enterectomy (24.1%). Recurrence surgery was most common in emergency procedures (OR 2.1; 95%CI 1.6–6.6). Montreal phenotype L1 stricture behavior (RR 1.3; 95%CI 1.0–1.8, p=0.04) and perianal disease (RR 1.43; 95%CI 1.2–1.7) increased the risk of emergency surgeries. The multiple linear regression showed age at diagnosis as a risk factor for surgery (p=0.004). The study of surgery free time showed no difference in the Kaplan-Meier curve for Montreal classification (p=0.73). CONCLUSIONS: The risk factors for operative intervention were strictures in ileal and jejunal diseases, age at diagnosis, perianal disease, and emergency indications.

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Predictive Factors for Loss of Response to Anti-TNF in Crohn’s Disease

Cited by 3 publications

References 17 publications

Nutrition, Nutritional Status, Micronutrients Deficiency, and Disease Course of Inflammatory Bowel Disease

Nutrition, Nutritional Status, Micronutrients Deficiency, and Disease Course of Inflammatory Bowel Disease

Expressão De E-Caderina E Claudina-3 No Epitélio Cólico Após Terapia Com Infliximabe: Modelo Experimental De Colite De Exclusão

Assessment of Risk Factors for Surgery Treatment of Crohn’s Disease: A Hospital Cohort

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