Levels of anti-double-strained DNA but not antinuclear antibodies are associated with treatment efficacy and adverse outcomes in Crohn's disease patients treated with anti-TNFα

Lajos S. Kiss, Barbara D. Lovasz, Petra A. Golovics, Zsuzsanna Vegh, Klaudia Farkas, Tamas Molnar, Karoly Palatka, Maria Papp, Anna Mohas, Blanka K. Szilagyi, Szandra A. Fekete, Michael Mandel, Peter L. Lakatos

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background & Aims: Treatment of Crohn's disease (CD) by infliximab (IFX) has been associated with the induction of antinuclear (ANA) and anti-double strand DNA (dsDNA) autoantibodies and in some studies the formation of dsDNA antibodies was associated with lupus-like syndromes. The aims of this study were to analyse the relationship between the development of ANA and dsDNA antibodies during anti-tumor necrosis factor (TNF)α therapy and the clinical efficacy or adverse outcome in patients with inflammatory bowel disease (IBD). Methods: Data of 96 CD patients (age at presentation: 25.1 years, folow-up: 5 years, males/females 43/53) treated with anti-TNFα for at least one-year were analyzed. Records of a total of 198 one-year treatment cycles were collected and levels of autoantibodies were determined at induction and after one-year treatment periods. Results: The majority of CD patients had ileocolonic (67.4%) and complicated disease (B2-B3: 72.6%) with perianal lesions (63.2%). At any time ANA or dsDNA positivity was 28.6% and 18%. Elevated level of ANA at induction or during anti-TNFα therapy was not associated with treatment efficacy or development of adverse outcomes. In contrast, treatment efficacy (dsDNA positivity no/partial response vs. remission: 68.5% vs. 31.5%, P=0.003) was inferior and adverse outcomes were more frequent in patients with dsDNA positivity during the anti-TNFα therapy in both univariate analysis and in logistic regression models (OR efficacy: 4.91, 95%CI: 1.15-20.8; OR adverse outcome: 3.81,95%CI 1.04-13.9). Conclusions: Our data suggest that development of dsDNA during biological therapy may be associated with suboptimal treatment efficacy and adverse outcomes in CD patients.

Original languageEnglish
Pages (from-to)135-140
Number of pages6
JournalJournal of Gastrointestinal and Liver Diseases
Volume22
Issue number2
Publication statusPublished - Jun 1 2013

Keywords

  • Adverse outcome
  • Anti-TNFα therapy
  • Antinuclear antibody
  • Crohns's disease
  • Doubl-strand DNA

ASJC Scopus subject areas

  • Gastroenterology

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