| dc.creator |
Lin, S. |
|
| dc.creator |
Chanchlani, N. |
|
| dc.creator |
Carbery, I. |
|
| dc.creator |
Janjua, M. |
|
| dc.creator |
Nice, R. |
|
| dc.creator |
McDonald, T. J. |
|
| dc.creator |
Bewshea, C. |
|
| dc.creator |
Kennedy, N. A. |
|
| dc.creator |
Ahmad, T. |
|
| dc.creator |
Selinger, C. P. |
|
| dc.creator |
Goodhand, J. R. |
|
| dc.date |
2022-12-08T14:31:39Z |
|
| dc.date |
2022-12-08T14:31:39Z |
|
| dc.date |
2022-09-01 |
|
| dc.date |
2022-07-01 |
|
| dc.date.accessioned |
2023-02-17T19:48:10Z |
|
| dc.date.available |
2023-02-17T19:48:10Z |
|
| dc.identifier |
Aliment Pharmacol Ther. 2022 Sep;56(5):783-793. doi: 10.1111/apt.17089. Epub 2022 Jun 29. |
|
| dc.identifier |
35768996 |
|
| dc.identifier |
10.1111/apt.17089 |
|
| dc.identifier |
https://rde.dspace-express.com/handle/11287/622633 |
|
| dc.identifier |
Alimentary pharmacology & therapeutics |
|
| dc.identifier.uri |
http://localhost:8080/xmlui/handle/CUHPOERS/242007 |
|
| dc.description |
BACKGROUND: During illness, adaptations of the hypothalamic-pituitary-thyroid axis reduce energy expenditure, protein catabolism and modulate immune responses to promote survival. Lower serum free triiodothyronine-to-thyroxine (fT3/fT4) ratio has been linked to non-response to treatment in a range of diseases, including in biologic-treated patients with inflammatory bowel disease. AIM: To assess whether baseline serum fT3/fT4 ratio predicted primary non-response (PNR) and non-remission to infliximab and adalimumab in patients with Crohn's disease METHODS: Thyroid function tests were undertaken in stored serum from biologic-naïve adult patients with active luminal Crohn's disease immediately prior to treatment with infliximab (427 originator; 122 biosimilar) or adalimumab (448) in the Personalised Anti-TNF Therapy in Crohn's Disease study (PANTS). RESULTS: Baseline median [IQR] fT3/fT4 ratios were lower in women than men (0.30 [0.27-0.34] vs 0.32 [0.28-0.36], p < 0.001), in patients with more severe inflammatory disease, and in patients receiving corticosteroids (0.28 [0.25-0.33] vs. 0.32 [0.29-0.36], p < 0.001). Multivariable logistic regression analysis demonstrated that fT3/fT4 ratio was independently associated with PNR at week 14 (odds ratio [OR] 0.51, 95% confidence interval [CI] 0.31-0.85, p = 0.009), but not non-remission or changes in faecal calprotectin concentrations at week 54. The optimal threshold to determine PNR was 0.31 (area under the curve 0.57 [95% CI 0.54-0.61], sensitivity 0.62 [95% CI 0.41-0.74], and specificity 0.53 [95% CI 0.42-0.73]). CONCLUSIONS: Lower baseline serum fT3/fT4 ratio was associated with female sex, corticosteroid use and disease activity. It predicted PNR to anti-TNF treatment at week 14, but not non-remission at week 54. |
|
| dc.description |
The article is available via Open Access. Click on the 'Additional link' above to access the full-text. |
|
| dc.description |
Published version, accepted version (12 month embargo) |
|
| dc.language |
eng |
|
| dc.publisher |
Wiley |
|
| dc.rights |
© 2022 The Authors. Alimentary Pharmacology & Therapeutics published by John Wiley & Sons Ltd. |
|
| dc.rights |
http://creativecommons.org/publicdomain/zero/1.0/ |
|
| dc.subject |
Adalimumab/therapeutic use |
|
| dc.subject |
Adult |
|
| dc.subject |
*Biological Products |
|
| dc.subject |
*Crohn Disease/diagnosis/drug therapy |
|
| dc.subject |
Female |
|
| dc.subject |
Humans |
|
| dc.subject |
Infliximab/therapeutic use |
|
| dc.subject |
Male |
|
| dc.subject |
Thyroid Function Tests |
|
| dc.subject |
Thyroxine/therapeutic use |
|
| dc.subject |
Treatment Failure |
|
| dc.subject |
Triiodothyronine |
|
| dc.subject |
Tumor Necrosis Factor Inhibitors |
|
| dc.subject |
Crohn’s disease |
|
| dc.subject |
Ibd |
|
| dc.subject |
Pants |
|
| dc.subject |
T3 |
|
| dc.subject |
T4 |
|
| dc.subject |
Tsh |
|
| dc.subject |
low T3 syndrome |
|
| dc.subject |
low T3/T4 ratio |
|
| dc.subject |
non-thyroidal illness syndrome |
|
| dc.subject |
sick euthyroid syndrome |
|
| dc.title |
Understanding anti-TNF treatment failure: does serum triiodothyronine-to-thyroxine (T3/T4) ratio predict therapeutic outcome to anti-TNF therapies in biologic-naïve patients with active luminal Crohn's disease? |
|
| dc.type |
Journal Article |
|
| dc.type |
ppublish |
|