Serological markers for prediction of response to anti-tumor necrosis factor treatment in Crohn's disease

Am J Gastroenterol. 2002 Jun;97(6):1458-62. doi: 10.1111/j.1572-0241.2002.05689.x.


Objectives: The use of monoclonal anti-tumor necrosis factor (TNF) antibodies (infliximab, Remicade) is a new therapeutic approach for severe refractory luminal or fistulizing, Crohn's disease (CD). However, up to 30% of patients do not respond to this treatment. So far, no parameters predictive of response to anti-TNF have been identified. Our aim was to determine whether serological markers ASCA (anti-Saccharomyces cerevisiae antibodies) or pANCA (perinuclear antineutrophil cytoplasmic antibodies) could identify Crohn's patients likely to benefit from anti-TNF therapy.

Methods: Serum samples of 279 CD patients were analyzed for ASCA and pANCA before anti-TNF therapy. A blinded physician determined clinical response at week 4 (refractory luminal CD) or week 10 (fistulizing CD) after the first infusion of infliximab (5 mg/kg).

Results: Overall, there was no relationship between ASCA or pANCA and response to therapy. However, lower response rates were observed for patients with refractory intestinal disease carrying the pANCA+/ASCA- combination, although this lacked significance (p = 0.067).

Conclusions: In this cohort of infliximab-treated patients, neither ASCA nor pANCA could predict response to treatment. However, the combination pANCA+/ASCA- might warrant further investigation for its value in predicting nonresponse in patients with refractory luminal disease.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Antibodies, Antineutrophil Cytoplasmic / analysis*
  • Antibodies, Fungal / analysis*
  • Antibodies, Monoclonal / therapeutic use*
  • Cohort Studies
  • Crohn Disease / drug therapy*
  • Crohn Disease / immunology*
  • Forecasting
  • Gastrointestinal Agents / therapeutic use*
  • Humans
  • Infliximab
  • Middle Aged
  • Saccharomyces cerevisiae / immunology*
  • Single-Blind Method
  • Treatment Outcome


  • Antibodies, Antineutrophil Cytoplasmic
  • Antibodies, Fungal
  • Antibodies, Monoclonal
  • Gastrointestinal Agents
  • Infliximab