P625 A prospective study to assess the effectiveness of tacrolimus therapy in ulcerative colitis. (16th January 2018)

• Record Type: Journal Article
• Authors: Kishi, M; Hirai, F; Takatsu, N; Takada, Y; Yutaka, Y; Takeda, T; Yao, K; Matsui, T; Ueki, T
• Is Part Of: Journal of Crohn's and colitis. Volume 12:Number 1(2018:Jan.)Supplement 1
• Page Start: S425
• Page End: S426
• Publication Date: 2018-01-16
• Subjects: Inflammatory bowel diseases -- Periodicals; 616.344005
• DOI: 10.1093/ecco-jcc/jjx180.752
• Languages: English
• ISSNs: 1873-9946

Abstract

Abstract: Background: In ulcerative colitis (UC) treatment, an association between the effectiveness of tacrolimus (Tac) and changes in its trough levels by CYP3A5 gene polymorphism has been reported. However, very few reports have examined such association in a prospective study. We therefore conducted a prospective study to investigate the clinical and endoscopic effectiveness of Tac and its changes in trough levels by gene polymorphism. Methods: A prospective clinical study was conducted in UC patients undergoing Tac treatment. Genotyping to detect polymorphisms was conducted in 13 patients who gave consent. The clinical and endoscopic effectiveness was evaluated using the Lichtiger scale and Mayo endoscopic score (MES) at 12 weeks. Results: Clinical evaluation at 12 weeks was conducted in 14 patients. The clinical response rate was 64.3% (9 of 14) and the remission rate among responders was 77.8% (7 of 9). Endoscopic evaluation at 12 weeks was conducted in 11 patients. Response rate in these patients was 27.3% (9 of 11) and the mucosal healing rate among the responders was 66.7% (6 of 9). There were 10 non-expressers (non-EX group) and 3 expressers (EX group) in the 13 patients who were genotyped. The changes in trough level were not significantly different between the non-EX group and EX group. Of the 13 genotyped patients, 12 patients were available for clinical evaluation at 12 weeks, and the response rate among these patients was not significantly different between the non-EX group (77.8%, 7 of 9) and the EX group (66.7%, 2 of 3) ( p -value = 0.62). Remission rate among responders was 85.7% (6 of 7) in the non-EX group and 50.0% (1 of 2) in the EX group. All 13 genotyped patients were available for endoscopic evaluation at 12 weeks, and the response rate among these patients was not significantly different between the non-EX group (80.0%, 8 of 10) and the EX group (33.3%, 1 of 3) ( p -value = 0.20). Mucosal healing rate was 62.5% (5 of 10) in the non-EX group and 33.3% (1 of 3) in the EX group with no significant differences ( p -value = 0.61). Conclusions: When the trough level was adjusted appropriately, significant differences in trough level changes by gene polymorphism were not observed. There were also no differences in the clinical and endoscopic effectiveness.