Predictors of tissue healing in ulcerative colitis patients treated with anti-TNF

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• 作者：Nikos Viazis^a ; ^{nikos.viazis@gmail.com} ; Marios Giakoumis^a ; Giorgos Bamias^b ; Dimitris Goukos^c ; Theodoros Koukouratos^a ; Konstantina Katopodi^a ; Pantelis Karatzas^a ; Christos Triantos^d ; Chrisostomos Tsolias^d ; Georgios Theocharis^d ; George L. Daikos^c ; Spyros D. Ladas^b ; Dimitrios G. Karamanolis^a ; Gerasimos J. Mantzaris^a
• 关键词：Anti-TNF therapy ; Mucosal healing ; Ulcerative colitis
• 刊名：Digestive and Liver Disease
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：49
• 期：1
• 页码：29-33
• 全文大小：499 K
• 卷排序：49

文摘

To identify factors predicting mucosal healing in ulcerative colitis patients treated with anti-TNFα agents with or without azathioprine.MethodsIn a prospective, multicenter, one-year study biologic naïve patients aged 25–65 years, with corticosteroid-dependent or refractory colitis received combination treatment with anti-TNFα and azathioprine for 6 months followed by anti-TNFα monotherapy. Patients who denied combination therapy or were outside this age range received anti-TNFα monotherapy (controls). Before and at weeks 12 and 54 of treatment the total Mayo score was calculated. Mucosal healing was defined as endoscopic subscore of 0. Mucosal expression of T helper (Th) cell-lineage specific transcription factors (Tbet, Gata3, Rorc, FoxP3) before treatment was also associated with mucosal healing.ResultsOf 67 patients, 58 (86.6%) received combination and 9 (13.4%) anti-TNFα monotherapy. Overall 29 (43.3%) patients achieved mucosal healing; rates were higher in patients receiving combination therapy vs. monotherapy (p = 0.03) and in azathioprine naïve vs. exposed patients in the combination group (p = 0.01). Mucosal healing was associated with lower pre-treatment mucosal expression of transcription factor Th1–Tbet (p < 0.05) and higher expression of Th17–Rorc (p < 0.05).ConclusionsMucosal healing was associated with combination therapy, especially in biologic and azathioprine-naïve patients and pre-treatment mucosal expression of specific Th specific transcripting factors (Tbet and Rorc).