TY - JOUR T1 - Impact of comorbidities on anti-TNFα response and relapse in patients with inflammatory bowel disease: the VERNE study JF - BMJ Open Gastroenterology JO - BMJ Open Gastro DO - 10.1136/bmjgast-2019-000351 VL - 7 IS - 1 SP - e000351 AU - Ignacio Marin-Jimenez AU - Guillermo Bastida AU - Ana Forés AU - Esther Garcia-Planella AU - Federico Argüelles-Arias AU - Pilar Sarasa AU - Ignacio Tagarro AU - Alonso Fernández-Nistal AU - Carmen Montoto AU - Mariam Aguas AU - Javier Santos-Fernández AU - Marta Maia Bosca-Watts AU - Rocio Ferreiro AU - Olga Merino AU - Xavier Aldeguer AU - Xavier Cortés AU - Beatriz Sicilia AU - Francisco Mesonero AU - Manuel Barreiro-de Acosta Y1 - 2020/03/01 UR - http://bmjopengastro.bmj.com//content/7/1/e000351.abstract N2 - Objective To evaluate the impact of comorbidities and extraintestinal manifestations of inflammatory bowel disease on the response of patients with inflammatory bowel disease to antitumour necrosis factor alpha (anti-TNFα) therapy.Design Data from 310 patients (194 with Crohn’s disease and 116 with ulcerative colitis) treated consecutively with the first anti-TNFα in 24 Spanish hospitals were retrospectively analysed. Univariate and multivariate logistic regression analyses were performed to assess the associations between inflammatory bowel disease comorbidities and extraintestinal manifestations with anti-TNFα treatment outcomes. Key clinical features, such as type of inflammatory bowel disease and concomitant treatments, were included as fixed factors in the model.Results Multivariate logistic regression analyses (OR, 95% CI) showed that chronic obstructive pulmonary disease (2.67, 1.33 to 5.35) and hepato-pancreato-biliary diseases (1.87, 1.48 to 2.36) were significantly associated with primary non-response to anti-TNFα, as was the use of corticosteroids and the type of inflammatory bowel disease (ulcerative colitis vs Crohn’s disease). It was also found that myocardial infarction (3.30, 1.48 to 7.35) and skin disease (2.73, 1.42 to 5.25) were significantly associated with loss of response, along with the use of corticosteroids and the type of inflammatory bowel disease (ulcerative colitis vs Crohn’s disease).Conclusions Our results suggest that the presence of some comorbidities in patients with inflammatory bowel disease, such as chronic obstructive pulmonary disease and myocardial infarction, and of certain extraintestinal manifestations of inflammatory bowel disease, such as hepato-pancreato-biliary conditions and skin diseases, appear to be related to failure to anti-TNFα treatment. Therefore, their presence should be considered when choosing a treatment.Trial registration number NCT02861118. ER -