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Transfer of Manipulated Tumor-associated Neutrophils into Tumor-Bearing Mice to Study their Angiogenic Potential In Vivo
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Loss of Response to Anti-TNFs: Definition, Epidemiology, and Management

Giulia Roda1, Bindia Jharap2, Narula Neeraj1

  • 1The Leona M. Harry B. Helmsley Inflammatory Bowel Disease Center, The Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, USA.

Clinical and Translational Gastroenterology
|January 8, 2016
PubMed

Insights

Tumor necrosis factor-α (TNFα) antagonists improve inflammatory bowel disease care but many patients experience primary non-response or loss of response. This review covers definitions, risk factors, and management strategies for these common challenges.

Area of Science:

  • Gastroenterology and Immunology
  • Pharmacology and Therapeutics

Background:

  • Tumor necrosis factor-α (TNFα) antagonists have significantly improved inflammatory bowel disease (IBD) management.
  • These therapies reduce surgeries and hospitalizations, enhancing patient quality of life.
  • However, primary non-response (PNR) and loss of response (LOR) remain significant clinical challenges.

Purpose of the Study:

  • To provide a comprehensive overview of primary non-response (PNR) and loss of response (LOR) to TNFα antagonists in IBD.
  • To define PNR and LOR and discuss their epidemiology and associated risk factors.
  • To explore therapeutic strategies for managing patients experiencing LOR.

Main Methods:

  • Literature review and synthesis of existing data on TNFα antagonist efficacy in IBD.
  • Analysis of definitions, epidemiological data, and risk factors for PNR and LOR.
  • Discussion of current and emerging therapeutic options for managing treatment failure.

Main Results:

  • PNR and LOR affect a substantial proportion of IBD patients treated with TNFα antagonists.
  • Several risk factors contribute to the development of PNR and LOR.
  • Management of LOR involves strategies such as dose escalation, switching to alternative agents, or combination therapy.

Conclusions:

  • Understanding PNR and LOR is crucial for optimizing TNFα antagonist therapy in IBD.
  • Personalized treatment approaches are needed to address non-response and loss of response.
  • Further research is warranted to improve patient outcomes and identify novel therapeutic targets.

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