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Impact of HLA-DQA1*05 Genotype in Immunogenicity and Failure to Treatment with Tumour Necrosis Factor-alpha Antagonists in Inflammatory Bowel Disease: A Systematic Review and Meta-analysis.
Rodríguez-Alcolado, Leticia; Grueso-Navarro, Elena; Arias, Ángel; Lucendo, Alfredo J; Laserna-Mendieta, Emilio J.
Afiliación
  • Rodríguez-Alcolado L; Department of Gastroenterology, Hospital General de Tomelloso, Tomelloso, Spain.
  • Grueso-Navarro E; Department of Public Health, Universidad de Alcalá, Alcalá de Henares, Spain.
  • Arias Á; Department of Gastroenterology, Hospital General de Tomelloso, Tomelloso, Spain.
  • Lucendo AJ; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas [CIBERehd], Madrid, Spain.
  • Laserna-Mendieta EJ; Instituto de Investigación Sanitaria de Castilla -La Mancha [IDISCAM], Toledo, Spain.
J Crohns Colitis ; 18(7): 1034-1052, 2024 Aug 06.
Article en En | MEDLINE | ID: mdl-38219222
ABSTRACT

BACKGROUND:

HLA-DQA1*05 carriage has been associated with an increased risk of immunogenicity in patients with immune-mediated inflammatory diseases treated with tumour necrosis factor-alpha [TNF-a] antagonists. Results have shown an inconsistent association with a loss of response [LOR] in patients with inflammatory bowel disease [IBD], which could be modified when using proactive optimisation and association with immunomodulatory drugs.

AIMS:

To define the association of HLA-DQA1*05 on anti-drug antibody development and loss of response [LOR] to anti-TNF-a in IBD.

METHODS:

We searched MEDLINE, EMBASE, and SCOPUS, for the period up to August 2023, to identify studies reporting the risk of immunogenicity and/or LOR in IBD patients with HLA-DQA1*05 genotype.

RESULTS:

A total of 24 studies comprising 12 papers, 11 abstracts and one research letter, with a total of 5727 IBD patients, were included. In a meta-analysis of 10 studies [2984 patients; 41.9% with HLA-DQA1*05 genotype], HLA-DQA1*05 carriers had higher risk of immunogenicity compared with non-carriers (risk ratio, 1.54; 95% confidence interval [CI], 1.23 - 1.94; I2 = 62%) [low certainty evidence]. Lack of therapeutic drug monitoring [TDM] increased immunogenicity in the presence of risk human leukocyte antigen [HLA] [risk ratio 1.97; 95% CI, 1.35 - 2.88; I2 = 66%], whereas proactive TDM revoked this association [very low certainty of evidence]. A meta-analysis of six studies [765 patients] found that risk for secondary LOR was higher among HLA-DQA1*05 carriers [hazard ratio 2.21; 95% CI, 1.69 - 2.88; I2 = 0%] [very low certainty evidence], although definition and time to assessment varied widely among studies.

CONCLUSION:

HLA-DQA1*05 carriage may be associated with an increased risk of immunogenicity and secondary LOR in IBD patients treated with TNF-a antagonists.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedades Inflamatorias del Intestino / Factor de Necrosis Tumoral alfa / Cadenas alfa de HLA-DQ / Genotipo Tipo de estudio: Prognostic_studies / Systematic_reviews Límite: Humans Idioma: En Revista: J Crohns Colitis Asunto de la revista: GASTROENTEROLOGIA Año: 2024 Tipo del documento: Article País de afiliación: España Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedades Inflamatorias del Intestino / Factor de Necrosis Tumoral alfa / Cadenas alfa de HLA-DQ / Genotipo Tipo de estudio: Prognostic_studies / Systematic_reviews Límite: Humans Idioma: En Revista: J Crohns Colitis Asunto de la revista: GASTROENTEROLOGIA Año: 2024 Tipo del documento: Article País de afiliación: España Pais de publicación: Reino Unido