Effects of Tumor Necrosis Factor Antagonists in Patients With Primary Sclerosing Cholangitis

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Effects of Tumor Necrosis Factor Antagonists in Patients With Primary Sclerosing Cholangitis

Hedin, Charlotte Rose Hawkey (författare): Karolinska Institutet,Karolinska Institute,Karolinska University Hospital,Karolinska Univ Hosp, Div Gastroenterol, Med Unit Gastroenterol Dermatovenereol & Rheumato, Stockholm, Sweden.;Karolinska Inst, Dept Med Solna, Stockholm, Sweden.

Sado, Gina (författare): Karolinska University Hospital,Karolinska Univ Hosp, Dept Gastroenterol & Hepatol, Stockholm, Sweden.

Ndegwa, Nelson (författare): Karolinska Institutet,Karolinska Institute,Karolinska Inst, Dept Med Epidemiol & Biostat, Stockholm, Sweden.,Acad Med Ctr, Dept Gastroenterol & Hepatol, Amsterdam, Netherlands.,Academic Medical Center of University of Amsterdam (AMC)

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Lytvyak, Ellina (författare): University of Alberta,Univ Alberta, Fac Med & Dent, Katz Grp, Ctr Pharm & Hlth Res, Edmonton, AB, Canada.

Mason, Andrew (författare): University of Alberta,Univ Alberta, Fac Med & Dent, Katz Grp, Ctr Pharm & Hlth Res, Edmonton, AB, Canada.

Montano-Loza, Aldo (författare): University of Alberta,Univ Alberta, Fac Med & Dent, Katz Grp, Ctr Pharm & Hlth Res, Edmonton, AB, Canada.

Gerussi, Alessio (författare): University College London,University of Udine,UCL, Inst Liver & Digest Hlth, Sheila Sherlock Liver Ctr, Royal Free London Natl Hlth Serv Fdn Trust, London, England.;Univ Udine, Dept Med, Internal Med Unit, Udine, Italy.

Saffioti, Francesca (författare): University College London,University of Messina

Thorburn, Douglas (författare): University College London,UCL, Inst Liver & Digest Hlth, Sheila Sherlock Liver Ctr, Royal Free London Natl Hlth Serv Fdn Trust, London, England.

Nilsson, Emma (författare): Lund University,Lunds universitet,Gastro,Forskargrupper vid Lunds universitet,Lund University Research Groups,Skåne University Hospital,Lund Univ, Skane Univ Hosp, Gastroenterol Clin, Lund, Sweden.

Larsson, Geir (författare): Oslo university hospital,Oslo Univ Hosp, Dept Gastroenterol & Hepatol, Clin Med, Oslo, Norway.

Moum, Bjørn A. (författare): Oslo university hospital,Oslo Univ Hosp, Dept Gastroenterol & Hepatol, Clin Med, Oslo, Norway.

van Munster, Kim N. (författare): Academic Medical Center of University of Amsterdam (AMC)

Ponsioen, Cyriel Y. (författare): Academic Medical Center of University of Amsterdam (AMC),Acad Med Ctr, Dept Gastroenterol & Hepatol, Amsterdam, Netherlands.

Levy, Cynthia (författare): University of Miami,Univ Miami, Miller Sch Med, Div Hepatol, Miami, FL 33136 USA.

Nogueira, Nicholas F. (författare): University of Miami,Univ Miami, Schiff Ctr Liver Dis, Miami, FL USA.

Bowlus, Christopher L. (författare): University of California, Davis,Univ Calif Davis, Dept Internal Med, Div Gastroenterol & Hepatol, Sacramento, CA 95817 USA.

Gotlieb, Neta (författare): Tel-Aviv University,Tel Aviv Univ, Dept Gastroenterol & Hepatol, Tel Aviv Sourasky Med Ctr, Tel Aviv, Israel.

Shibolet, Oren (författare): Tel-Aviv University,Tel Aviv Univ, Dept Gastroenterol & Hepatol, Tel Aviv Sourasky Med Ctr, Tel Aviv, Israel.

Lynch, Kate D. (författare): University of Oxford,Univ Oxford, Nuffield Dept Med, Translat Gastroenterol Unit, Oxford, England.

Chapman, Roger W. (författare): University of Oxford,Univ Oxford, Nuffield Dept Med, Translat Gastroenterol Unit, Oxford, England.

Rupp, Christian (författare): University Hospital Heidelberg,Univ Hosp Heidelberg, Dept Internal Med 4, Heidelberg, Germany.

Vesterhus, Mette (författare): Haraldsplass Deaconess Hosp, Dept Med, Bergen, Norway.

Jørgensen, Kristin K. (författare): Akershus University Hospital,Akershus Univ Hosp, Dept Gastroenterol, Lorenskog, Norway.

Rorsman, Fredrik, Docent, 1960- (författare): Uppsala universitet,Gastroenterologi/hepatologi,Uppsala University Hospital

Schramm, Christoph (författare): University Medical Center Hamburg-Eppendorf,Univ Med Ctr Hamburg Eppendorf, Dept Med 1, Martin Zeitz Ctr Rare Dis, Hamburg, Germany.

Sabino, João (författare): University Hospitals Leuven,Katholieke Univ Leuven, Univ Hosp Leuven, Dept Gastroenterol & Hepatol, Leuven, Belgium.

Vermeire, Severine (författare): University Hospitals Leuven,Katholieke Univ Leuven, Univ Hosp Leuven, Dept Gastroenterol & Hepatol, Leuven, Belgium.

Zago, Alessandra (författare): University of Padova,Univ Padua, Dept Surg Oncol & Gastroenterol, Padua, Italy.

Cazzagon, Nora (författare): University of Padova,Univ Padua, Dept Surg Oncol & Gastroenterol, Padua, Italy.

Marschall, Hanns-Ulrich (författare): Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine

Ytting, Henriette (författare): Hvidovre Hospital,Hvidovre Univ Hosp, Dept Med Gastroenterol, Dept Hepatol, Rigshospitalet, Copenhagen, Denmark.

Ben Belkacem, Karima (författare): Hospital Saint-Antoine,Sorbonne Univ, French Reference Ctr Inflammatory Biliary Dis & A, French Network Rare Liver Dis Adults & Children, St Antoine Hosp,AP HP,Ctr Rech St Antoine CRSA,He, Paris, France.

Chazouilleres, Olivier (författare): Hospital Saint-Antoine,Sorbonne Univ, French Reference Ctr Inflammatory Biliary Dis & A, French Network Rare Liver Dis Adults & Children, St Antoine Hosp,AP HP,Ctr Rech St Antoine CRSA,He, Paris, France.

Almer, Sven (författare): Karolinska Institutet

Bergquist, Annika (författare): Karolinska Institutet

Saffi, Francesc (författare): UCL, Inst Liver & Digest Hlth, Sheila Sherlock Liver Ctr, Royal Free London Natl Hlth Serv Fdn Trust, London, England.;Univ Messina, Dept Clin & Expt Med, Messina, Italy.

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Elsevier BV, 2020
2020
Engelska.
Ingår i: Clinical Gastroenterology and Hepatology. - : Elsevier BV. - 1542-3565 .- 1542-7714. ; 18:10, s. 2-2304

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Background & Aims: Few patients with primary sclerosing cholangitis (PSC) and inflammatory bowel diseases (IBDs) are exposed to tumor necrosis factor (TNF) antagonists because of the often mild symptoms of IBD. We assessed the effects of anti-TNF agents on liver function in patients with PSC and IBD, and their efficacy in treatment of IBD. Methods: We performed a retrospective analysis of 141 patients with PSC and IBD receiving treatment with anti-TNF agents (infliximab or adalimumab) at 20 sites (mostly tertiary-care centers) in Europe and North America. We collected data on the serum level of alkaline phosphatase (ALP). IBD response was defined as either endoscopic response or, if no endoscopic data were available, clinical response, as determined by the treating clinician or measurements of fecal calprotectin. Remission was defined more stringently as endoscopic mucosal healing. We used linear regression analysis to identify factors associated significantly with level of ALP during anti-TNF therapy. Results: Anti-TNF treatment produced a response of IBD in 48% of patients and remission of IBD in 23%. There was no difference in PSC symptom frequency before or after drug exposure. The most common reasons for anti-TNF discontinuation were primary nonresponse of IBD (17%) and side effects (18%). At 3 months, infliximab-treated patients had a median reduction in serum level of ALP of 4% (interquartile range, reduction of 25% to increase of 19%) compared with a median 15% reduction in ALP in adalimumab-treated patients (interquartile range, reduction of 29% to reduction of 4%; P =.035). Factors associated with lower ALP were normal ALP at baseline (P <.01), treatment with adalimumab (P =.090), and treatment in Europe (P =.083). Conclusions: In a retrospective analysis of 141 patients with PSC and IBD, anti-TNF agents were moderately effective and were not associated with exacerbation of PSC symptoms or specific side effects. Prospective studies are needed to investigate the association between use of adalimumab and reduced serum levels of ALP further.

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MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Klinisk medicin; och Gastroenterologi

Artiklar i publikationen: Clinical Gastroe ...

Av lärosätet: Lunds universitet; Uppsala universitet; Karolinska Institutet; Göteborgs universitet

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Effects of Tumor Necrosis Factor Antagonists in Patients With Primary Sclerosing Cholangitis

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