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. 2020 Nov 20;33(2):e1522.
doi: 10.1590/0102-672020200002e1522. eCollection 2020.

PREDICTIVE FACTORS FOR LOSS OF RESPONSE TO ANTI-TNF IN CROHN'S DISEASE

[Article in English, Portuguese]
Byanca Rossetti Moreira Dos Santos  1 , Carlos Henrique Marques Dos Santos  1   2 , Vitória Rossetti Moreira Dos Santos  1 , Claudia Yanina Garcia Torrez  1 , Daniel Palomares-Junior  1
Affiliations

PREDICTIVE FACTORS FOR LOSS OF RESPONSE TO ANTI-TNF IN CROHN'S DISEASE

[Article in English, Portuguese]
Byanca Rossetti Moreira Dos Santos et al. Arq Bras Cir Dig. .

Abstract
in English, Portuguese

Background: Anti-TNF drugs are a fundamental part of the treatment of Crohn's disease (CD), so identifying factors related to loss of response is of great importance in clinical practice.

Aim: Identify potential factors related to loss of response to anti-TNF agents in Crohn's disease patients.

Methods: This is a prospective study of CD patients attending a specialized outpatient clinic using a specific form, including patients with more than one year of follow-up on anti-TNF (Infliximab, Adalimumab or Certolizumab pegol). The information obtained was tabulated and analyzed to identify possible reasons for the loss of response to anti-TNF agents; results were submitted to statistical analysis by chi-square teste considering significant p<0.05.

Results: Sixty-four patients were included, most of them females (56.3%), predominant age group between 26 and 55 years, of whom 25 required optimization, 23 remained in remission with the usual dose and interval, and 16 required switch; most of those who needed switch had hematological problems such as anemia and/or had already undergone surgical treatment for CD.

Conclusions: Anemia and prior CD surgery have been linked to loss of anti-TNF response.

Racional:: Os anti-TNF são parte fundamental no tratamento da doença de Crohn (DC), portanto, identificar os fatores relacionados à perda de resposta tem grande importância na prática clínica.

Objetivo:: Identificar potenciais fatores relacionados a perda de resposta aos agentes anti-TNF em pacientes com DC.

Métodos:: Trata-se de um estudo prospectivo de pacientes com DC frequentadores de ambulatório especializado por meio de formulário específico, incluindo-se pacientes com mais de um ano de acompanhamento em uso de anti-TNF (Infliximabe, Adalimumabe ou Certolizumabe pegol). As informações obtidas foram tabuladas e analizadas para identificação de eventuais motivos para a perda de resposta aos agentes; os resultados foram submetidos a tratamento estatístico por meio do teste qui-quadrado considerando-se significante p<0,05.

Resultados:: Foram incluídos 64 pacientes, sendo a maioria do sexo feminino (56,3%), faixa etária predominante entre 26 e 55 anos, dos quais 25 necessitaram otimização, 23 se mantiveram em remissão com a dose e intervalo habituais, e 16 necessitaram troca de medicamento; a maioria dos que necessitaram troca tinham alterações hematológicas como anemia e/ou já haviam sido submetidos a tratamento cirúrgico pela doença.

Conclusões:: Anemia e operação prévia por DC foram relacionados a perda de resposta aos anti-TNF.

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Conflict of interest statement

Conflict of interest: none

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