Abstract Background Carrying the HLA-DQA1*05 gene has been linked to a higher risk of developing immunogenicity in patients with inflammatory bowel disease (IBD) who are treated with tumor necrosis factor-alpha inhibitors (antiTNF). However, studies have shown inconsistent evidence regarding its connection to a loss of response (LOR) or adverse events in patients with IBD MethodsAims To determine the impact of carriage of HLADQA105 allele on effectiveness, drug persistence and safety in patients diagnosed with IBD who had received antiTNF. Methods Retrospective, single-center cohort study including IBD patients who had received antiTNF. The HLA-DQA105 allele was determined from a saliva sample (kit OGD-600 de DNA Genotek Oragene) and DNA extraction with the Maxwell RSC-Stabilized Saliva DNA kits. We evaluate drug persistence, withdrawal of antiTNF, primary non-response and secondary LOR, through antiTNF levels, development of antiTNF antibodies and adverse events in patients distributed by HLA-DQA105 allele presence Results A total of 170 patients were included, 51% male, mean age 46.2, 120 (70.6%) diagnosed with Crohn’s disease. The mean disease duration was 189.6 months. Fifty patients (29.4%) had extraintestinal manifestations and 30% comorbidities. HLA-DQA105 was positive in 44% patients. One hundred twenty-seven patients (75%) received infliximab and 25% adalimumab. AntiTNF was the first advanced therapy in 95% of the cohort. Seventy-five out of 170 patients (44%) received an intensified antiTFN regimen, as well as 47% were treated with combotherapy with immunosuppressants. AntiTNF was withdrawn in 52% patients during follow-up, and the rate of adverse events that led to discontinuation of the drug was 17.6%. When we compared the rate of primary non-response (12.2% vs.7.5%. p = 0.3) and secondary LOR (48% vs. 44%, p = 0.5), withdrawal of antiTNF (48% vs.54%, p = 0.5), duration of antiTNF (85.3 ± 69.1 months vs. 90.3 ± 76.4, p = 0.3), need of intensified regimen (47% vs.42%, p = 0.4),use of combotherapy (46% vs.49%, p = 0.6) and antiFNF levels (2.6 ± 2.3 vs. 2.9 vs. 2.9, p = 0.3) we did not find significant differences between patients by HLA-DQA105 status. The infusion reactions rate (8.1% vs.11.8%, p = 0.4), development of anti-TNF antibodies (9.5 vs.10.8, p = 0.7), overall (14.9 vs.19.4), rate of adverse events (14.9 vs.24.7, p = 0.5) or adverse events that led to drug withdrawal (14.9 vs19.4, p = 0.4) were also similar among patients regardless HLA-DQA1*05 Conclusion In our real-life cohort of IBD patients treated with antiTNF, being an HLA-DQA1*05 carrier did not act as a predictor of effectiveness (primary non-response or secondary LOR), immugenicity or need of intensified regimen. The safety of anti-TNF treatment has also not been influenced by the variant Conflict of interest: Ms. Moreno Torres, Violeta: No conflict of interest Mira, Cristina: No conflict of interest Madero Velázquez, Lucía: No conflict of interest Muñoz, Roser: No conflict of interest Belén Galipienso, Olivia: No conflict of interest Cameo Lorenzo, Jose Ignacio: No conflict of interest Bernal Lujan, Lorena: No conflict of interest García Trueba, Antonio: No conflict of interest Sempere Robles, Laura: No conflict of interest Gutiérrez Casbas, Ana: No conflict of interest
Torres et al. (Thu,) studied this question.