Role of Vitamin D in Infliximab-induced Remission in Adult Patients with Crohnʼs Disease

Reich, Krista; Fedorak, Richard N.; Madsen, Karen; Kroeker, Karen I.

doi:10.1097/mib.0000000000000588

Cited by 24 publications

(16 citation statements)

References 40 publications

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“…Santos-Antunes et al demonstrated that extreme vitamin D deficiency (<20 ng/ml) was associated with serum antinuclear antibody (ANA) positivity, anti-TNF failure, and adverse events (OR = 20.11, 95% CI: 2.10-192.39) (69). However, Reich et al found that CD patients with a low serum vitamin D level had a higher clinical remission rate at 14 weeks than patients with normal vitamin D levels (80% vs. 23%, P = 0.007) (70).…”

Section: Vitamin Dmentioning

confidence: 98%

Serum Biomarkers for Inflammatory Bowel Disease

et al. 2020

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Background: Inflammatory bowel disease (IBD), including Crohn's disease and ulcerative colitis, is a chronic, inflammatory disorder of the gastrointestinal tract. As the novel therapeutic goal and biologicals are widely recognized, accurate assessment of disease and prediction of therapeutic response have become a crucial challenge in clinical practice. Also, because of the continuously rising incidence, convenient and economical methods of diagnosis and clinical assessment are urgently needed. Recently, serum biomarkers have made a great progress and become a focus in IBD study because they are non-invasive, convenient, and relatively inexpensive than are markers in biopsy tissue, stool, breath, and other body fluids. Aims: To review the available data on serological biomarkers for IBD. Methods: We searched PubMed using predefined key words on relevant literatures of serum biomarkers regarding diagnosis, evaluation of therapeutic efficacy, surveillance of disease activity, and assessment of prognosis for IBD. Results: We reviewed serological biomarkers that are well-established and widely used (e.g., C-reactive protein), newly discovered biomarkers (e.g., cytokines, antibodies, and non-coding RNAs), and also recently advancements in serological biomarkers (e.g., metabolomics and proteomics) that are used in different aspects of IBD management. Conclusions: With such a wealth of researches, to date, there are still no ideal serum biomarkers for IBD. Serum profiling and non-coding RNAs are just starting to blossom but reveal great promise for future clinical practice. Combining different biomarkers can be valuable in improving performance of disease evaluation.

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Section: Vitamin Dmentioning

confidence: 98%

Serum Biomarkers for Inflammatory Bowel Disease

et al. 2020

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“…Recent studies investigated a possible correlation between vitamin D levels and clinical response to infliximab therapy. Here, low baseline vitamin D concentration was associated with heightened probability of primary clinical remission at week 14 in CD patients ( 116 ). Another study in IBD patients, found a significant link between deficiency of vitamin D and the presence of ANA, which were found to be associated with failure to anti-TNF therapy and also reported as significant risk factors for anti-TNF induced adverse events associated with anti-TNF therapy ( 72 ).…”

Section: Blood Markersmentioning

confidence: 98%

Personalizing Treatment in IBD: Hype or Reality in 2020? Can We Predict Response to Anti-TNF?

2020

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The advent of anti-TNF agents as the first approved targeted therapy in the treatment of inflammatory bowel disease (IBD) patients has made a major impact on our existing therapeutic algorithms. They have not only been approved for induction and maintenance treatment in IBD patients, but have also enabled us to define and achieve novel therapeutic outcomes, such as combination of clinical symptom control and endoscopic remission, as well as mucosal healing. Nevertheless, approximately one third of treated patients do not respond to initiated anti-TNF therapy and these treatments are associated with sometimes severe systemic side-effects. There is therefore the currently unmet clinical need do establish predictive markers of response to identify the subgroup of IBD patients, that have a heightened probability of response. There have so far been approaches from different fields of IBD research, to descry markers that would empower us to apply TNF-inhibitors in a more rational manner. These markers encompass findings from disease-related and clinical factors, pharmacokinetics, biochemical markers, blood and stool derived parameters, pharmacogenomics, microbial species, metabolic compounds, and mucosal factors. Furthermore, changes in the intestinal immune cell composition in response to therapeutic pressure of anti-TNF treatment have recently been implicated in the process of molecular resistance to these drugs. Insights into factors that determine resistance to anti-TNF therapy give reasonable hope, that a more targeted approach can then be utilized in these non-responders. Here, IL-23 could be identified as one of the key factors determining resistance to TNF-inhibitors. Growing insights into the molecular mechanism of action of TNF-inhibitors might also enable us to derive critical molecular markers that not only mediate the clinical effects of anti-TNF therapy, but which level of expression might also correlate with its therapeutic efficacy. In this narrative review, we present an overview of currently identified possible predictive markers for successful anti-TNF therapy and discuss identified molecular pathways that drive resistance to these substances. We will also point out the necessity and difficulty of developing and validating a diagnostic marker concerning clinically relevant outcome parameters, before they can finally enter daily clinical practice and enable a more personalized therapeutic approach.

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“…From a clinical point of view, the administration of tumor necrosis factor (TNF)‐alpha inhibitor is associated with higher vitamin D levels in IBD . On the other hand, in CD patients where infliximab was initiated, lower vitamin D levels were associated with a higher rate of clinical remission at week 14 …”

Section: Introductionmentioning

confidence: 99%

Vitamin D administration leads to a shift of the intestinal bacterial composition in Crohn's disease patients, but not in healthy controls

Schäffler

Herlemann

Klinitzke

et al. 2018

J of Digest Diseases

106

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Role of Vitamin D in Infliximab-induced Remission in Adult Patients with Crohnʼs Disease

Abstract: Crohn's patients initiating infliximab with a low vitamin D level are more likely to achieve infliximab-induced clinical remission at week 14.

Cited by 24 publications

References 40 publications

Serum Biomarkers for Inflammatory Bowel Disease

Serum Biomarkers for Inflammatory Bowel Disease

Personalizing Treatment in IBD: Hype or Reality in 2020? Can We Predict Response to Anti-TNF?

Vitamin D administration leads to a shift of the intestinal bacterial composition in Crohn's disease patients, but not in healthy controls

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