Kopylov Uri, Seidman Ernest
Division of Gastroenterology, Sheba Medical Center, Tel Hashomer and Sackler Faculty of Medicine, Tel Aviv, Israel.
Professor of Medicine and Pediatrics McGill University, Director, IBD Center of Excellence at McGill, Bruce Kaufman Endowed Chair in IBD at McGill, Canada Research Chair in Immune Mediated Gastrointestinal Disorders, Digestive Lab Research Institute of the McGill University Health Centre, 1650 Cedar Avenue C10.145, Montreal, QC H3G 1A4, Canada.
Therap Adv Gastroenterol. 2016 Jul;9(4):513-26. doi: 10.1177/1756283X16638833. Epub 2016 Apr 1.
Monoclonal antibodies to tumor necrosis factor (TNF) have become a mainstay of the therapeutic armamentarium in inflammatory bowel disease (IBD) over the last 15 years. Although highly effective, primary and secondary nonresponse are common and associated with poor clinical outcomes and significant costs. Multiple clinical, genetic and immunopharmacological factors may impact the response to anti-TNFs. Early stratification of IBD patients by the expected risk of therapeutic failure during the induction and maintenance phases of treatment may allow for treatment optimization and potentially optimal short- and long-term outcomes. The aim of this review is to summarize the current data concerning the potential predictors of therapeutic success and failure of anti-TNFs in IBD.
在过去15年中，肿瘤坏死因子（TNF）单克隆抗体已成为炎症性肠病（IBD）治疗手段的中流砥柱。尽管疗效显著，但原发性和继发性无反应很常见，且与不良临床结局及高昂费用相关。多种临床、遗传和免疫药理学因素可能影响对抗TNF药物的反应。在治疗的诱导期和维持期，根据预期治疗失败风险对IBD患者进行早期分层，可能有助于优化治疗，并可能实现最佳的短期和长期结局。本综述的目的是总结目前关于IBD中抗TNF药物治疗成功和失败的潜在预测因素的数据。
