Analysis of the factors related to anti-TNF alpha response in the treatment of Crohn's Disease / Análise dos fatores relacionados à resposta e à ausência/perda de resposta ao anticorpo antifator de necrose tumoral-alfa no tratamento da doença de Crohn

ABSTRACT

Crohn's disease (CD) presents a great challenge regarding treatment, considering that the best drugs available have very limited effectiveness. OBJECTIVE: To analyze the characteristics between groups of patients with Crohn's disease who had response versus had not/lost response to treatment with anti-TNF. METHOD: Retrospective study of patients with CD treated with IFX or ADA. RESULTS: We studied 72 patients with mean age of 35 years; 45 of them were treated with infliximab and 27 with adalimumab; 90% of women were respondents, compared to 10% who were not respondents/lost response, and 60% of men were respondents versus 40% who were not respondents/lost response; there was no difference between IFX and ADA with respect to response; 48 patients were < 40 and 24 > 40 years old. Of those who had < 40 years, 37 were respondents, compared to 11 who were not respondents/lost response. Of those with > 40 years, 16 were respondents versus 8 who were not respondents/lost response; patients under 2 years of diagnosis had a better response than those with two to five years of symptoms, and these latter exhibited a better response than those with more than five years of diagnosis. CONCLUSION: The observed characteristics of response to treatment of CD with anti-TNF were association to azathioprine, female gender, age < 40 years and less than two years of diagnosis. (AU)

RESUMO

A doença de Crohn (DC) apresenta um grande desafio quanto ao seu tratamento, considerando-se que os melhores medicamentos disponíveis têm eficácia bastante limitada. OBJETIVO: Analisar as características entre os grupos de pacientes com DC que responderam e os que não responderam ou perderam a resposta ao tratamento com anti-TNF. MÉTODO: Estudo retrospectivo de pacientes com DC que fizeram uso de IFX ou ADA. RESULTADOS: Foram estudados 72 pacientes com média de idade de 35 anos; 45 foram tratados com adalimumabe e 27 com infliximabe; 90% das mulheres tiveram resposta, contra 10 que não tiveram/perderam resposta; dos homens, 60% tiveram resposta contra 40% que não tiveram/perderam resposta; não houve diferença entre IFX e ADA quanto à resposta; 48 tinham menos de 40 anos e 24 mais de 40 anos. Dos com < 40 anos, 37 tiveram resposta, contra 11 que não tiveram/perderam resposta. Daqueles com > 40 anos, 16 tiveram resposta contra 8 que não tiveram/perderam resposta; pacientes com menos de 2 anos de diagnóstico tiveram melhor resposta do que aqueles com dois a cinco anos de sintomas; e estes tiveram melhor resposta que aqueles com mais de cinco anos de diagnóstico. CONCLUSÃO: As características observadas de melhor resposta ao tratamento da DC com anti-TNF foram associação com azatioprina, gênero feminino, idade menor de 40 anos e menos de dois anos de diagnóstico. (AU)