Study background: Anti tumor necrosis factor-α is thought to play an important role in the treatment of Crohn’s disease. However, loss
of response to anti tumor necrosis factor-α remains problematic. We aimed to assess loss of response to anti tumor necrosis factor-α in the
treatment of Crohn’s disease and clarify factors associated with loss of response.
Methods: We analyzed loss of response in 128 patients with Crohn’s disease from multiple centers. All the patients were naïve to anti tumor
necrosis factor-α at the time of the initial treatment. The Kaplan-Meier method, Rank test, and Cox regression analyses were used in the
Results: Twenty-five percent of the patients were women, and the median age of the patients was 31 years (interquartile range 22.0-43.2
years). Loss of response to infliximab and adalimumab treatments was recognized in 26 (28.8%) of 90 patients and in 7 (18.4%) of 38
patients, respectively. In the multivariate Cox regression analysis, the presence of an ileitis lesion and a high C-reactive protein level (≥2.25
mg/dL) before treatment induction were identified as independent risk factors for predicting loss of response (hazard ratio=2.563, p<0.05
and hazard ratio=5.317, p<0.05, respectively).
Conclusion: The C-reactive protein level of the patients prior to anti tumor necrosis factor-α therapy is an important factor to consider when
predicting loss of response in anti tumor necrosis factor-α naïve patients.