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P203. Levels of anti-double-strained DNA but not antinuclear antibodies in patients with IBD treated by anti-TNFs are associated with adverse outcomes

L.S. Kiss1, B.D. Lovasz1, P.A. Golovics1, Z. Vegh1, K. Farkas2, T. Molnar2, K. Palatka3, A. Mohas1, B.K. Szilagyi1, S.A. Fekete1, P. Lakatos1, 1Semmelweis University, 1st Department of Medicine, Budapest, Hungary, 2Szeged, 1st Department of Medicine, Szeged, Hungary, 3University of Debrecen, 2nd Department of Medicine, Debrecen, Hungary

Background

Treatment of Crohn's disease (CD) by infliximab has been associated with the induction of antinuclear (ANA) and anti-double stranded DNA (dsDNA) autoantibodies and in some studies the formation of dsDNA antibodies was associated with lupus-like syndromes. The aim of this study was to analyze the relationship between the development ANA and ds-DNA antibodies during anti TNF therapy and adverse outcome (LOR, allergy, lupus like syndrome, induced autoimmune disorders) in patients with inflammatory bowel diseases (IBD).

Methods

Data of 105 (96 CD, age at diagnosis: 27.1 SD: 10.05 years, duration: 8.2 SD 6.6 years, males/females 48/57) patients treated with anti-TNFs for at least one-year. Records of a total of 198 one-year treatment cycles were collected and levels of auto antibodies were determined at induction and after the one-year period.

Results

The majority of CD patients had ileocolonic (67.4%) and complicated (B2-B3: 72.6%) with perianal lesions (63.2%). ANA (12.3%) but not dsDNA positivity was frequent already and induction. Any time ANA or dsDNA positivity was 28.6% and 18%. Elevated level of ANA at induction time or during anti-TNF therapy was not associated with the efficacy of the therapy or the development of adverse outcomes. In contrast, treatment efficacy (no/partial response, dsDNA positivity: 31.5% vs. 68.5%, p = 0.003) was inferior and adverse outcomes were more frequent (dsDNA positivity: 38.7% vs. 14.6%, p = 0.01, OR: 3.71, 95% CI: 1.31–10.5) in patients with dsDNA positivity.

Conclusion

Our data suggest that development of ds-DNA during biological therapy is associated with treatment efficacy and adverse outcomes.