Pharmacokinetic stratification of cytokine profiles during anti-TNF induction treatment in moderate-to-severe ulcerative colitis
Up to 30% of ulcerative colitis patients are primary non-responders to treatment with anti-TNF therapy. This research explores the underlying reasons.
Anti-tumor necrosis factor (TNF) agents were the first biologics used to treat ulcerative colitis (UC). TNF plays a role in the regulation of immune cells and is believed to be a driver of inflammation in UC. However, up to 30% of ulcerative colitis patients are primary non-responders to anti-TNF therapy.1
Clinical collaborators from Amsterdam UMC, UMC Ljubljana, KU Leuven, and Biora presented patient data from an independent study to learn more about the markers of inflammation present in ulcerative colitis patients before, during, and after anti-TNF induction treatment with either infliximab or adalimumab.
What did we find?
Pharmacodynamic failure, or primary non-response, was characterized by highest tissue levels of interleukin 6 (IL6), a pro-inflammatory cytokine
IL6 may be a driver of inflammation alternative to TNF in ulcerative colitis
Combination therapy targeting other inflammation pathways in addition to TNF might improve outcomes in patients who are primary anti-TNF non responders.
- Roda G, Jharap B, Neeraj N, Colombel JF. Loss of Response to Anti-TNFs: Definition, Epidemiology, and Management. Clin Transl Gastroenterol. 2016;7(1):e135. Published 2016 Jan 7. doi:10.1038/ctg.2015.63