Predictors of tissue healing in ulcerative colitis patients treated with anti-TNF
| Autor: | Dimitris Goukos, Nikos Viazis, George L. Daikos, Konstantina Katopodi, Christos Triantos, Gerasimos J. Mantzaris, Georgios Theocharis, Marios Giakoumis, Chrisostomos Tsolias, T. Koukouratos, Dimitrios G. Karamanolis, Giorgos Bamias, Spyros D. Ladas, Pantelis Karatzas |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Adult
Male medicine.medical_specialty Combination therapy Azathioprine Severity of Illness Index Gastroenterology 03 medical and health sciences 0302 clinical medicine Refractory RAR-related orphan receptor gamma Internal medicine medicine Humans Prospective Studies Intestinal Mucosa Colitis Aged Wound Healing Greece Hepatology Tumor Necrosis Factor-alpha business.industry Adalimumab GATA3 Antibodies Monoclonal FOXP3 Colonoscopy Middle Aged Nuclear Receptor Subfamily 1 Group F Member 3 medicine.disease Ulcerative colitis Infliximab Logistic Models Treatment Outcome 030220 oncology & carcinogenesis Colitis Ulcerative Drug Therapy Combination Female 030211 gastroenterology & hepatology T-Box Domain Proteins business Immunosuppressive Agents medicine.drug |
| Zdroj: | Digestive and Liver Disease. 49:29-33 |
| ISSN: | 1590-8658 |
| DOI: | 10.1016/j.dld.2016.10.008 |
| Popis: | Aim To identify factors predicting mucosal healing in ulcerative colitis patients treated with anti-TNFα agents with or without azathioprine. Methods In a prospective, multicenter, one-year study biologic naive 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. Results Of 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 naive 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 Conclusions Mucosal healing was associated with combination therapy, especially in biologic and azathioprine-naive patients and pre-treatment mucosal expression of specific Th specific transcripting factors (Tbet and Rorc). |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect