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Dig Dis Sci ; 55(6): 1674-80, 2010 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-19693669

RESUMO

PURPOSE: Factors influencing response to medications in Crohn's disease (CD) patients are not fully understood. We aimed to evaluate the relationships between NOD2/CARD15 mutations, disease phenotype and age of CD diagnosis and response to medical treatment with systemic steroids, azathioprine (AZA) or 6-mercaptopurine (6-MP), and infliximab. METHODS: A retrospective medical records analysis was made of patients previously tested for the CD-associated NOD2/CARD15 mutations. Harvey- Bradshaw score was used to assess remission or response to therapy. RESULTS: CD-associated NOD2/CARD15 mutations were not related to the rate of steroids dependency or clinical response to AZA/6-MP and infliximab. Steroid dependency was associated with colonic involvement. Thirty-three of 127 (26%) patients with colonic disease were steroid dependent, compared with 7/72 (9.7%) patients with isolated small bowel disease (ISBD), (p = 0.009). ISBD was mildly associated with a better remission/response to AZA/6-MP treatment. Disease behavior and age of diagnosis were not related to response to therapy. CONCLUSIONS: Response to treatment with systemic steroids, AZA/6-MP and infliximab are not related to NOD2/CARD15 mutations, age of diagnosis and disease behavior. Patients with colonic disease have higher rates of steroid dependency.


Assuntos
Anti-Inflamatórios/uso terapêutico , Doença de Crohn/tratamento farmacológico , Fármacos Gastrointestinais/uso terapêutico , Mutação , Proteína Adaptadora de Sinalização NOD2/genética , Adolescente , Adulto , Fatores Etários , Anticorpos Monoclonais/uso terapêutico , Azatioprina/uso terapêutico , Distribuição de Qui-Quadrado , Doença de Crohn/diagnóstico , Doença de Crohn/genética , Feminino , Predisposição Genética para Doença , Humanos , Infliximab , Israel , Estudos Longitudinais , Masculino , Mercaptopurina/uso terapêutico , Pessoa de Meia-Idade , Fenótipo , Estudos Retrospectivos , Esteroides/uso terapêutico , Resultado do Tratamento , Adulto Jovem
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