The efficacy of immunomodulators in the prevention and suppression of anti-drug antibodies to anti-tumor necrosis factor therapy in inflammatory bowel disease

Fotios S Fousekis; Konstantinos Papamichael; Georgios Kourtis; Eleni N Albani; Afroditi Orfanidou; Maria Saridi; Konstantinos H Katsanos; Dimitrios K Christodoulou

doi:10.20524/aog.2021.0682

The efficacy of immunomodulators in the prevention and suppression of anti-drug antibodies to anti-tumor necrosis factor therapy in inflammatory bowel disease

Ann Gastroenterol. 2022 Jan-Feb;35(1):1-7. doi: 10.20524/aog.2021.0682. Epub 2021 Dec 6.

Authors

Fotios S Fousekis¹, Konstantinos Papamichael², Georgios Kourtis³, Eleni N Albani⁴, Afroditi Orfanidou⁵, Maria Saridi⁶, Konstantinos H Katsanos¹, Dimitrios K Christodoulou¹

Affiliations

¹ Department of Gastroenterology, School of Health Sciences, University Hospital of Ioannina, Faculty of Medicine, University of Ioannina, Ioannina, Greece (Fotios S. Fousekis, Konstantinos H. Katsanos, Dimitrios K. Christodoulou).
² Center for Inflammatory Bowel Diseases, Division of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA (Konstantinos Papamichael).
³ Department of Department of Nursing, "Sotiria" General Hospital, Athens, Greece (Georgios Kourtis).
⁴ Department of Nursing, University of Patra, Patra, Greece (Eleni N. Albani).
⁵ Academic Department of Gastroenterology, Laiko General Hospital, Medical School of National Kapodistrian University of Athens, Greece (Afroditi Orfanidou).
⁶ Department of Nursing, University of Thessaly, Lamia, Greece (Maria Saridi).

Abstract

The development of biological agents against tumor necrosis factor (TNF) has revolutionized the management of inflammatory bowel disease (IBD), frequently achieving induction and maintenance of remission in both ulcerative colitis and Crohn's disease. However, a loss of response due to the development of anti-drug antibodies (ADA) is seen annually in approximately 20% of IBD patients receiving anti-TNF therapy. Current evidence suggests that the use of immunomodulators (IMM), such as thiopurines (azathioprine and 6-mercaptopurine) or methotrexate, may prevent or suppress ADA formation. In this article, we present a comprehensive review of the available literature regarding the efficacy of IMM in the prevention and suppression of ADA development to anti-TNF therapy in patients with IBD.

Keywords: anti-TNF; anti-drug antibodies; inflammatory bowel disease; methotrexate; thiopurines.

Publication types

Review