Infliximab resistance in inflammatory bowel disease and factors affecting resistance

Infliximab Resistance in Inflammatory Bowel Disease and Factors Affecting Resistance Inflammatory Bowel Disease (IBD) is a chronic disease characterized by inflammation in the gastrointestinal tract. IBD includes Ulcerative Colitis (UC) and Crohn's Disease (CD).Since it is a disease with inflammation in the intestine, the role of anti-TNF agents in its treatment is important.Infliximab (IFX) is the first anti-TNF agent approved for IBD.It is important to determine the resistance rate in patients as it affects the remission of the disease and the treatment response.In this study, it was aimed to determine the rate of infliximab resistance in IBD in our region.In addition, the relationship between the demographic characteristics of the patients, the subtype and age of the disease and antibody positivity was also tried to be determined. Patients (total of 40 patients) who were followed up in the Gastroenterology clinic of Aydın Adnan Menderes University Hospital and applied between October 2020 and October 2021, diagnosed with UC, CD and tested for infliximab resistance in their blood were included in the study.Demographic characteristics of the patients such as age and gender, types of disease involvement, duration of disease, comorbidities and drugs they used, laboratory parameters at the beginning of treatment, and other treatments used together with infliximab were recorded.Statistical analysis was done with SPSS program.P<0.05 was considered statistically significant. 27 of the patients were diagnosed with UC and 13 with CD.The mean age was 39.3±11.7 years in patients with UC and 46.3±15.8 years in CD.Infliximab antibody was positive in 25.0% of all patients, 29.6% of patients with UC, and 15.4% of patients with CD.The mean age of anti-IFX antibody positive patients was 39.4±14.0 years and 42.3±13.3 years in negative patients.Antibody was positive in 20.0% of women and 28.0% of men.When the laboratory values were examined, the median sedimentation value was found to be 42.5 in patients with positive infliximab antibody and 29.5 in negative patients.Infliximab antibody was positive in 33.3% of those who received another Anti-TNF treatment before infliximab and in 22.6% of those who did not. In our study, the infliximab resistance rate was found to be 25% in IBD patients in and around Aydın. Infliximab resistance was higher in patients with UC.In our study, more antibody positivity was detected at younger ages.In addition, less antibody positivity was observed in patients using corticosteroid and azathioprine together with infliximab.Our study is important in terms of reflecting the resistance rate of IBD patients receiving infliximab in Aydın and its surroundings, as well as the demographic and clinical factors associated with it.We think that the results of our study will guide other studies. Keywords: Inflammatory bowel disease, Infliximab resistance, Anti drug antibody