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Serological markers associated with disease behavior and response to anti‐tumor necrosis factor therapy in ulcerative colitis
Author(s) -
Kevans David,
Waterman Matti,
Milgrom Raquel,
Xu Wei,
Van Assche Gert,
Silverberg Mark
Publication year - 2015
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.12661
Subject(s) - medicine , serology , ulcerative colitis , gastroenterology , infliximab , odds ratio , colectomy , discontinuation , immunology , tumor necrosis factor alpha , antibody , disease
Background and Aim Information is limited on the relationship between serological markers and disease behavior and anti‐tumor necrosis factor‐α (anti‐TNF) therapy response in ulcerative colitis ( UC ). This study aimed to determine the association between serological markers and unfavorable UC behavior defined as need for colectomy or UC ‐related hospitalization. The association between serological markers and requirement for and outcome of anti‐ TNF therapy was also evaluated. Methods Two hundred thirty patients were studied. Requirement for colectomy, UC ‐related hospitalization, and anti‐ TNF therapy were documented. Response to anti‐ TNF therapy at 1 year and rates of therapy discontinuation were recorded. Titers of perinuclear anti‐neutrophil cytoplasmic antibodies ( pANCA s), anti‐ S accharomyces cerevisiae antibody ( ASCA ), and antibody to E scherichia C oli outer membrane porin (anti‐ O mp C ) were determined. Antibody reference ranges were used to dichotomize subjects into seropositive and seronegative groups. Where multiple tests were performed, P ‐values were B onferroni corrected (p corr ). Results Extensive colitis was associated with requirement for colectomy and UC ‐related hospitalization, HR 7.7 (95% confidence interval [ CI ] 1.9–32.2) p corr = 0.03 and HR 2.7 (95% CI 1.5–4.6), p corr = 0.006, respectively. No serological variable was associated with unfavorable UC behavior. Anti‐ O mp C positivity was associated with a lack of response to anti‐ TNF therapy at 1 year (odds ratio 0.14 [95% CI 0.03–0.60], p corr = 0.04) and increased likelihood of therapy discontinuation ( HR 2.2 [95% CI 1.1–4.7], P = 0.03). Conclusion Extensive colitis is associated with unfavorable disease course in UC . Anti‐ O mp C holds promise as a biomarker of anti‐ TNF therapy response in UC ; however, prospective studies are required before it can be incorporated into routine clinical practice.