Aparato Digestivo, Hospital Universitario Virgen Macarena, España.
UGC Aparato Digestivo, Hospital Universitario Juan Ramón Jiménez, España.
Rev Esp Enferm Dig. 2023 Nov;115(11):608-614. doi: 10.17235/reed.2023.9491/2023.
the success of strategies with earlier anti-TNF drugs for the treatment of inflammatory bowel disease (IBD) have been shadowed by the development of anti-drug antibodies that reduce their effectiveness. The HLA-DQA1*05 allele has been shown to increase the risk of immunogenicity to anti-TNF drugs by approximately two-fold. The negative impact of this allele has not been fully investigated for newer biotherapies.
whether the presence of the HLA-DQA1*05 allele is associated with a reduction of response to ustekinumab and vedolizumab was investigated.
the impact of HLA-DQA1*05 on disease activity in 93 patients with IBD, treated with ustekinumab (n = 39) or vedolizumab (n = 54) was investigated in a retrospective cohort study. Treatment response and remission was assessed at 6 and 12 months for ustekinumab, and up to 18 and 24 months for vedolizumab, using Harvey-Bradshaw index (Crohn's disease) and Mayo score (ulcerative colitis).
the HLA-DQA105 allele was found in 35.9 % and 38.9 % of patients treated with ustekinumab and vedolizumab, respectively. Clinical response was not affected by the presence of the HLA-DQA105 allele for both treatment groups.
in contrast to anti-TNF drugs, HLA-DQA1*05 presence does not correlate with the decreased response to ustekinumab or vedolizumab.
尽管早期抗 TNF 药物治疗炎症性肠病(IBD)的策略取得了成功,但抗药物抗体的产生降低了其疗效,这一问题一直困扰着这些策略。HLA-DQA1*05 等位基因已被证明可使抗 TNF 药物产生免疫原性的风险增加约两倍。对于较新的生物疗法,尚未充分研究该等位基因的负面影响。
研究 HLA-DQA1*05 等位基因是否与乌司奴单抗和维得利珠单抗的应答降低有关。
在一项回顾性队列研究中,研究了 HLA-DQA1*05 对 93 例接受乌司奴单抗(n = 39)或维得利珠单抗(n = 54)治疗的 IBD 患者的疾病活动的影响。使用 Harvey-Bradshaw 指数(克罗恩病)和 Mayo 评分(溃疡性结肠炎)评估乌司奴单抗的治疗反应和缓解情况,分别在 6 个月和 12 个月,维得利珠单抗在 18 个月和 24 个月。
分别有 35.9%和 38.9%接受乌司奴单抗和维得利珠单抗治疗的患者携带 HLA-DQA105 等位基因。对于这两个治疗组,HLA-DQA105 等位基因的存在均不影响临床应答。
与抗 TNF 药物相反,HLA-DQA1*05 存在与乌司奴单抗或维得利珠单抗应答降低无关。