Does Gender Affect Response to Anti-TNFs Among Patients With UC?

Men with ulcerative colitis (UC) are less likely to achieve clinical remission, mucosal healing, and clinical response compared to women during induction treatment with anti-tumor necrosis factor (TNF) agents, recent research revealed.

However, the researchers reported, “There were no differences in outcomes by gender in the treatment and placebo arms in the meta-analysis of maintenance trials.”

Gender-based differences have been reported in the pathogenesis of IBD pathogenesis, but if and how these differences affect outcomes of IBD treatment have not been clear. In this study, the investigation gathered data from the Yale University Open Data Access (YODA) platform on individual participants from randomized clinical trials of the anti-TNFs infliximab and golimumab in moderate to severe UC as both induction and maintenance therapies.

“Using multivariable logistic regression, we examined associations between gender and the endpoints of clinical remission, mucosal healing, and clinical response for each study individually and in a meta-analysis,” the authors wrote.

Of 1639 patients included in induction trials, 696 (42.5%) were women, while 534 (41.7%) of the 1280 patients included in maintenance trials were women. “In a meta-analysis of induction trials, the adjusted odds ratios (aORs) of clinical remission (aOR, 0.55; 95% CI, 0.31–0.97), mucosal healing (aOR, 0.47; 95% CI, 0.27–0.83), and clinical response (aOR, 0.51; 95% CI, 0.29–0.90) in the treatment arm and of clinical remission in the placebo arm (aOR, 0.34; 95% CI, 0.15–0.82) were lower in men compared to women,” the authors wrote.

“Future studies delineating the mechanisms underlying these observations would be informative,” they concluded.

—Rebecca Mashaw

Reference:
Agrawal M, Petralia F, Tepler A. Gender-based differences in response to tumor necrosis factor inhibitor therapies for ulcerative colitis: Individual participant data meta-analyses of clinical trials. Inflamm Bowel Dis. Published online ahead of print. 2022.DOI: 10.1093/ibd/izac067