Ris, W. (Willem) (2019) Serum signature as a predictive tool for the response to infliximab therapy in Inflammatory Bowel Disease. thesis, Medicine.
Full text available on request.Abstract
Background: Crohn’s disease (CD) and ulcerative colitis (UC) are the two main types of Inflammatory Bowel Disease (IBD), and are putatively caused by an inappropriate immune response to commensal microbes in genetically susceptible individuals. Infusions with antibodies against TNF-α, such as infliximab, are effective in the induction and maintenance of remission in IBD. However, the response to infliximab therapy cannot be accurately predicted and primary non-responders will often be identified only after the induction phase of 14 weeks. Therefore, a non-invasive procedure to predict the response to infliximab therapy is needed. Aim: This study aims at identifying a set of serum biomarkers as a predictive tool for the response to infliximab therapy in patients with IBD. Methods: In 99 IBD patients (66 CD, 26 UC, 4 IBDU), the response to infliximab induction therapy was identified using the physician’s global assessment and clinical indices (HBI and SCCAI). Baseline serum levels of 14 different inflammatory biomarkers were analyzed using electrochemiluminescence (ECL). Logistic regression models and ROC analysis was used to identify the best combination of inflammatory biomarkers to predict the response to infliximab therapy. Results: A total of 9 non-responders, 52 responders and 38 patients in remission were identified. Due to the low number of non-responders no (set of) biomarker(s) could identify the primary non-responders. However, a combination of five different biomarkers (CRP, SAA, IFN-γ, IL-8, and IL-10) showed the ability (AUC = 0.779, CI = 0.665 - 0.869) to discriminate between response and remission. This set did not perform significantly better than a combination of just CRP, SAA and IFN-γ (AUC = 0.731, CI = 0.615 - 0.828). Conclusion: We did not found biomarkers to predict primary non-response but a combination of CRP, SAA and IFN-γ showed to be very sensitive in the discrimination between response and complete remission upon treatment with infliximab.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Dijkstra, Prof. dr. G. and Bourgonje, A. MD/PhD candidate |
| Faculty: | Medical Sciences |
| Keywords: | Gastroenterology, Inflammatory Bowel Disease, Infliximab therapy |
| Date Deposited: | 10 Jul 2020 07:38 |
| Last Modified: | 10 Jul 2020 07:38 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/2742 |
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