Predictors of primary response to biologic treatment (anti-TNF, vedolizumab and ustekinumab) in patients with inflammatory bowel disease: from basic science to clinical practice.
J Crohns Colitis. 2019 Nov 28;:
Authors: Gisbert JP, Chaparro M
BACKGROUND: Inflammatory bowel diseases (IBD) -ulcerative colitis and Crohn’s disease- are commonly treated with biologic drugs. However, only approximately two thirds have an initial response to these therapies. Personalized medicine has the potential to optimize efficacy, decrease the risk of adverse drug events, and reduce costs by establishing the most suitable therapy for a selected patient.
AIM: The present study reviews the potential predictors of short-term primary response to biologic treatment, including not only anti-TNF agents (such as infliximab, adalimumab, certolizumab and golimumab) but also vedolizumab and ustekinumab.
METHODS: We performed a systematic bibliographic search to identify studies investigating predictive factors of response to biologic therapy.
RESULTS: For anti-TNF agents most of the evaluated factors have not demonstrated to be useful, and many others are still controversial. Thus, only a few factors may have a potential role in the prediction of the response, including disease behavior/phenotype, disease severity, C-reactive protein, albumin, cytokine expression in serum, prior anti-TNF therapy, some proteomic markers, and some colorectal mucosa markers. For vedolizumab, the availability of useful predictive markers seems to be even lower, with only some factors showing a limited value, such as the expression of α4β7 integrin in blood, the fecal microbiota, some proteomic markers, and some colorectal mucosa markers. Finally, in the case of ustekinumab, no predictive factor has been reported yet to be helpful in clinical practice.
CONCLUSION: In summary, currently, no single marker fulfils all criteria for being an appropriate prognostic indicator of response to any biologic treatment in IBD.
PMID: 31777929 [PubMed – as supplied by publisher]