How to predict response to anti-tumour necrosis factor agents in inflammatory bowel disease

Samuele Naviglio, Paolo Giuffrida, Gabriele Stocco, Marco Vincenzo Lenti, Alessandro Ventura, Gino Roberto Corazza, Antonio Di Sabatino

Research output: Contribution to journalReview article

Abstract

INTRODUCTION: Anti-tumor necrosis factor (TNF) agents have changed the therapeutic approach to inflammatory bowel disease (IBD). However, a considerable proportion of patients either do not primarily respond or lose response to treatment. Despite the long-standing experience in the use of these drugs, still there is the need of identifying the possible predictors of efficacy. Areas covered: We critically review the current knowledge on predictors of response to anti-TNF therapy - both those available in clinical practice and those still under investigation. Multiple factors are involved in treatment success, including disease phenotype and severity, adherence to medications, and pharmacogenomic, pharmacokinetic, and immunologic factors. Literature search was conducted in PubMed using keywords 'inflammatory bowel disease,' 'Crohn's disease,' and 'ulcerative colitis,' matched with 'antitumor necrosis factor,' 'biologic therapy,' 'clinical response,' 'predictors,' and 'efficacy,' Relevant articles were selected for review. Expert commentary: While the role of several factors in clinical practice is clearly established, other investigational markers have been proposed, mostly in small studies, yet for many of them little external validation exists. Therapeutic drug monitoring is emerging as a pivotal strategy to guide decisions in clinical practice. In the near future, novel markers could improve our ability to direct treatment and personalize therapy.

Original languageEnglish
Pages (from-to)797-810
Number of pages14
JournalExpert Review of Gastroenterology and Hepatology
Volume12
Issue number8
DOIs
Publication statusPublished - Aug 2018

Keywords

  • Antibodies, Monoclonal/therapeutic use
  • Biological Therapy
  • Gastrointestinal Agents/therapeutic use
  • Humans
  • Inflammatory Bowel Diseases/drug therapy
  • Patient Selection
  • Prognosis
  • Treatment Outcome
  • Tumor Necrosis Factor-alpha/antagonists & inhibitors

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