152 153 Intestinal Disease Meeting Berlin 2006 - Dr. Falk Pharma ...

Fig. 22
CDP571
34
21
Placebo
I CRP and response to biologicals (S. Vermeire, Leuven)
49
15
Congress Short Report Falk Symposium
S. Vermeire K. Herrlinger
CRP helps assess patients’ reaction
to biologics
In addition to these serological markers, said
S. Vermeire (Leuven), there are also biomarkers
that could be used to better classify the disease
manifestation. Disease activity is most commonly
assessed using C-reactive protein (CRP), which
also predicts to a certain degree patients’ reaction
to biologics (figure 22). A further possible
marker is calprotectin, which is determined from
stool. Both CRP and calprotectin, S. Vermeire
said, are very sensitive markers for inflammation.
They are, however, not specific and can be
elevated in cases of infection or malignant
processes.
Response [%]
60
50
40
30
20
10
0
60
50
40
30
20
10
In the opinion of K. Herrlinger (Stuttgart), pharmacogenetic
studies could be used to predict
the reaction to a given therapeutic agent. He
cited azathioprine as an example. This immunosuppressant
helps maintain remission in many
patients and use of this agent helps spare corticosteroids.
Thiopurine S-methyltransferase
(TPMT), the enzyme responsible for the breakdown
of azathioprine, however, exhibits a genetic
polymorphism, with the result that there
are rapid, intermediate and slow metabolizers of
azathioprine. Patients’ status can be determined
prior to treatment, K. Herrlinger said, thus allowing
the physician to estimate to some degree the
risk of side effects and to adjust the medication
dose accordingly.
0
Week 2 all Week 2 CRP Week 12 all Week 12 CRP
> 10 mg/l
> 10 mg/l
44
37
CDP571
53
Placebo
18
153
33