P501 High TNF-production of CD14+ cells and short disease duration are independent predictive factors for response to Infliximab treatment
D. Lissner*1, B. Jessen1,2, E. Sonnenberg1, M. Schumann1, F. Schmidt1, Y. Rodriguez Sillke1, B. Siegmund1
1Charité – Universitätsmedizin Berlin, Campus Benjamin Franklin, Department for Medicine (Gastroenterology, Infectious diseases, Rheumatology), Berlin, Germany, 2Berlin Institute of Health, Berlin, Germany
A substantial rate of primary non-response to Infliximab in patients with inflammatory bowel disease (IBD) together with the increasing availability of alternative biologics emphasise the need for predictive markers to personalize treatment. Thus, the study’s aim was to identify predictive factors for response to Infliximab treatment.
21 patients with Crohn’s disease (CD) and 20 patients with ulcerative colitis (UC) without treatment with biologicals in the past 6 months were prospectively included into this observational study before their first Infliximab infusion. Harvey–Bradshaw-Index (HBI) or partial Mayo Score (pMS), C-reactive protein (CRP) and ultrasound (Limberg Score) served to quantify disease activity at baseline and Week 6, respectively. Cytokine production of LPS-stimulated PBMCs at baseline (TNF, IL-1, IL-6, IL-8, IL-10, IL-12p70) were measured by ELISA, CBA and flow cytometry. A ROC analysis for TNF-production was applied to estimate a cut-off to group patients into either low or high TNF-producers. Primary endpoint was clinical response defined as a decline in score of ≥ 2 (HBI) or ≥ 3 (pMS) at Week 6, secondary endpoints were decrease in CRP or Limberg score at Week 6. The need for urgent colectomy within the 6 weeks was defined as non-response. Mann–Whitney
41 patients (48.8% females) with a mean age of 38 (SD 12.8) were included in the analysis. Of these, 30 patients (73.2%) responded to Infliximab treatment. Responders had shorter disease duration (
High TNF-production of CD14+ cells at baseline and shorter disease duration were independent factors to predict response to Infliximab in IBD patients.