The Relevance of Vitamin D and Antinuclear Antibodies in Patients with Inflammatory Bowel Disease Under Anti-TNF Treatment: A Prospective Study

• Type: Article in International Scientific Journal
• Date: 2016

Authors

João Santos-Antunes (Author) FMUP; Nunes, ACR (Author) Other; Lopes, S (Author) Other; Macedo G (Author) FMUP

Journal

Title: Inflammatory Bowel Diseases

Vol. 22

Pages: 1101-1106

ISSN: 1078-0998

Publisher: Oxford University Press

Indexing

ISI Web of Knowledge - 33 Citations

Scopus - 32 Citations

Other information

Authenticus ID: P-00K-E8A

DOI: 10.1097/mib.0000000000000697

Abstract (EN): Background: The importance of vitamin D in inflammatory bowel disease (IBD) has been analyzed in former studies, namely concerning the severity of the disease and the efficacy of anti-tumor necrosis factor (TNF) medications. In several inflammatory conditions, biologics have been associated with an autoimmune response with formation of antinuclear antibodies (ANA). In addition, an inverse relationship between vitamin D levels and ANA has been documented. We aimed to evaluate the clinical importance of the link between vitamin D, ANA, and anti-TNF in patients with IBD. Methods: Prospective study including patients with IBD with indication to start anti-TNF, between 2009 and 2014. Deficiency and extreme deficiency of vitamin D were defined as levels of 25-hydroxyvitamin D below 20 and 4 ng/mL, respectively. ANA titers were considered positive if higher or equal to 1/100. Results: Among 68 patients (56 with Crohn's Disease, 12 with ulcerative colitis), vitamin D deficiency was detected in 93%. Pretreatment positivity for ANA was related to higher failure rates of anti-TNF treatment (P = 0.008). Pretreatment positivity for ANA and extreme vitamin D deficiency were significant risk factors for adverse events associated with anti-TNF therapy. A significant link was found between extreme deficiency of vitamin D and the presence of ANA. Conclusions: Our study highlights the association between vitamin D deficiency and pretreatment positivity for ANA with the risk for anti-TNF failure and adverse events, and the inverse relationship between vitamin D levels and ANA. Due to the high prevalence of vitamin D deficiency in IBD and the immune-mediated nature of the disease, these elements should be evaluated before starting biologics.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 6