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Pretreatment Vitamin D Concentrations Do Not Predict Therapeutic Outcome to Anti-TNF Therapies in Biologic-Naïve Patients With Active Luminal Crohn’s Disease
BACKGROUND AND AIMS: Vitamin D has a regulatory role in innate and adaptive immune processes. Previous studies have reported that low pretreatment vitamin D concentrations are associated with primary non-response (PNR) and non-remission to anti-TNF therapy. This study aimed to assess whether pretrea...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10231451/ https://www.ncbi.nlm.nih.gov/pubmed/37265586 http://dx.doi.org/10.1093/crocol/otad026 |
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author | Chanchlani, Neil Lin, Simeng Smith, Rebecca Roberts, Christopher Nice, Rachel McDonald, Timothy J Hamilton, Benjamin Bishara, Maria Bewshea, Claire Kennedy, Nicholas A Goodhand, James R Ahmad, Tariq |
author_facet | Chanchlani, Neil Lin, Simeng Smith, Rebecca Roberts, Christopher Nice, Rachel McDonald, Timothy J Hamilton, Benjamin Bishara, Maria Bewshea, Claire Kennedy, Nicholas A Goodhand, James R Ahmad, Tariq |
author_sort | Chanchlani, Neil |
collection | PubMed |
description | BACKGROUND AND AIMS: Vitamin D has a regulatory role in innate and adaptive immune processes. Previous studies have reported that low pretreatment vitamin D concentrations are associated with primary non-response (PNR) and non-remission to anti-TNF therapy. This study aimed to assess whether pretreatment 25-hydroxyvitamin D concentrations predicted PNR and non-remission to infliximab and adalimumab in patients with active luminal Crohn’s disease. METHODS: 25-Hydroxyvitamin D concentrations were measured in stored baseline samples from 659 infliximab- and 448 adalimumab-treated patients in the Personalised Anti-TNF Therapy in Crohn’s disease (PANTS) study. Cut-offs for vitamin D were deficiency <25 nmol/L, insufficiency 25–50 nmol/L, and adequacy/sufficiency >50 nmol/L. RESULTS: About 17.1% (189/1107; 95% CI, 15.0–19.4) and 47.7% (528/1107; 95% CI, 44.8–50.6) of patients had vitamin D deficiency and insufficiency, respectively. 22.2% (246/1107) of patients were receiving vitamin D supplementation. Multivariable analysis confirmed that sampling during non-summer months, South Asian ethnicity, lower serum albumin concentrations, and non-treatment with vitamin D supplementation were independently associated with lower vitamin D concentrations. Pretreatment vitamin D status did not predict response or remission to anti-TNF therapy at week 14 (infliximab P(pnr) = .89, adalimumab P(pnr) = .18) or non-remission at week 54 (infliximab P = .13, adalimumab P = .58). Vitamin D deficiency was, however, associated with a longer time to immunogenicity in patients treated with infliximab, but not adalimumab. CONCLUSIONS: Vitamin D deficiency is common in patients with active Crohn’s disease. Unlike previous studies, pretreatment vitamin D concentration did not predict PNR to anti-TNF treatment at week 14 or nonremission at week 54. |
format | Online Article Text |
id | pubmed-10231451 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-102314512023-06-01 Pretreatment Vitamin D Concentrations Do Not Predict Therapeutic Outcome to Anti-TNF Therapies in Biologic-Naïve Patients With Active Luminal Crohn’s Disease Chanchlani, Neil Lin, Simeng Smith, Rebecca Roberts, Christopher Nice, Rachel McDonald, Timothy J Hamilton, Benjamin Bishara, Maria Bewshea, Claire Kennedy, Nicholas A Goodhand, James R Ahmad, Tariq Crohns Colitis 360 Observations and Research BACKGROUND AND AIMS: Vitamin D has a regulatory role in innate and adaptive immune processes. Previous studies have reported that low pretreatment vitamin D concentrations are associated with primary non-response (PNR) and non-remission to anti-TNF therapy. This study aimed to assess whether pretreatment 25-hydroxyvitamin D concentrations predicted PNR and non-remission to infliximab and adalimumab in patients with active luminal Crohn’s disease. METHODS: 25-Hydroxyvitamin D concentrations were measured in stored baseline samples from 659 infliximab- and 448 adalimumab-treated patients in the Personalised Anti-TNF Therapy in Crohn’s disease (PANTS) study. Cut-offs for vitamin D were deficiency <25 nmol/L, insufficiency 25–50 nmol/L, and adequacy/sufficiency >50 nmol/L. RESULTS: About 17.1% (189/1107; 95% CI, 15.0–19.4) and 47.7% (528/1107; 95% CI, 44.8–50.6) of patients had vitamin D deficiency and insufficiency, respectively. 22.2% (246/1107) of patients were receiving vitamin D supplementation. Multivariable analysis confirmed that sampling during non-summer months, South Asian ethnicity, lower serum albumin concentrations, and non-treatment with vitamin D supplementation were independently associated with lower vitamin D concentrations. Pretreatment vitamin D status did not predict response or remission to anti-TNF therapy at week 14 (infliximab P(pnr) = .89, adalimumab P(pnr) = .18) or non-remission at week 54 (infliximab P = .13, adalimumab P = .58). Vitamin D deficiency was, however, associated with a longer time to immunogenicity in patients treated with infliximab, but not adalimumab. CONCLUSIONS: Vitamin D deficiency is common in patients with active Crohn’s disease. Unlike previous studies, pretreatment vitamin D concentration did not predict PNR to anti-TNF treatment at week 14 or nonremission at week 54. Oxford University Press 2023-05-15 /pmc/articles/PMC10231451/ /pubmed/37265586 http://dx.doi.org/10.1093/crocol/otad026 Text en © The Author(s) 2023. Published by Oxford University Press on behalf of Crohn's & Colitis Foundation. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Observations and Research Chanchlani, Neil Lin, Simeng Smith, Rebecca Roberts, Christopher Nice, Rachel McDonald, Timothy J Hamilton, Benjamin Bishara, Maria Bewshea, Claire Kennedy, Nicholas A Goodhand, James R Ahmad, Tariq Pretreatment Vitamin D Concentrations Do Not Predict Therapeutic Outcome to Anti-TNF Therapies in Biologic-Naïve Patients With Active Luminal Crohn’s Disease |
title | Pretreatment Vitamin D Concentrations Do Not Predict Therapeutic Outcome to Anti-TNF Therapies in Biologic-Naïve Patients With Active Luminal Crohn’s Disease |
title_full | Pretreatment Vitamin D Concentrations Do Not Predict Therapeutic Outcome to Anti-TNF Therapies in Biologic-Naïve Patients With Active Luminal Crohn’s Disease |
title_fullStr | Pretreatment Vitamin D Concentrations Do Not Predict Therapeutic Outcome to Anti-TNF Therapies in Biologic-Naïve Patients With Active Luminal Crohn’s Disease |
title_full_unstemmed | Pretreatment Vitamin D Concentrations Do Not Predict Therapeutic Outcome to Anti-TNF Therapies in Biologic-Naïve Patients With Active Luminal Crohn’s Disease |
title_short | Pretreatment Vitamin D Concentrations Do Not Predict Therapeutic Outcome to Anti-TNF Therapies in Biologic-Naïve Patients With Active Luminal Crohn’s Disease |
title_sort | pretreatment vitamin d concentrations do not predict therapeutic outcome to anti-tnf therapies in biologic-naïve patients with active luminal crohn’s disease |
topic | Observations and Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10231451/ https://www.ncbi.nlm.nih.gov/pubmed/37265586 http://dx.doi.org/10.1093/crocol/otad026 |
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