Potential impact of diet on treatment effect from anti-TNF drugs in inflammatory bowel disease

TY - JOUR

T1 - Potential impact of diet on treatment effect from anti-TNF drugs in inflammatory bowel disease

AU - Andersen, Vibeke

AU - Hansen, Axel Kornerup

AU - Heitmann, Berit Lilienthal

PY - 2017/3

Y1 - 2017/3

N2 - We wanted to investigate the current knowledge on the impact of diet on anti-TNF response in inflammatory bowel diseases (IBD), to identify dietary factors that warrant further investigations in relation to anti-TNF treatment response, and, finally, to discuss potential strategies for such investigations. PubMed was searched using specified search terms. One small prospective study on diet and anti-TNF treatment in 56 patients with CD found similar remission rates after 56 weeks among 32 patients with good compliance that received concomitant enteral nutrition and 24 with poor compliance that had no dietary restrictions (78% versus 67%, p = 0.51). A meta-analysis of 295 patients found higher odds of achieving clinical remission and remaining in clinical remission among patients on combination therapy with specialised enteral nutrition and Infliximab (IFX) compared with IFX monotherapy (OR 2.73; 95% CI: 1.73–4.31, p < 0.01, OR 2.93; 95% CI: 1.66–5.17, p < 0.01, respectively). In conclusion, evidence-based knowledge on impact of diet on anti-TNF treatment response for clinical use is scarce. Here we propose a mechanism by which Western style diet high in meat and low in fibre may promote colonic inflammation and potentially impact treatment response to anti-TNF drugs. Further studies using hypothesis-driven and data-driven strategies in prospective observational, animal and interventional studies are warranted.

AB - We wanted to investigate the current knowledge on the impact of diet on anti-TNF response in inflammatory bowel diseases (IBD), to identify dietary factors that warrant further investigations in relation to anti-TNF treatment response, and, finally, to discuss potential strategies for such investigations. PubMed was searched using specified search terms. One small prospective study on diet and anti-TNF treatment in 56 patients with CD found similar remission rates after 56 weeks among 32 patients with good compliance that received concomitant enteral nutrition and 24 with poor compliance that had no dietary restrictions (78% versus 67%, p = 0.51). A meta-analysis of 295 patients found higher odds of achieving clinical remission and remaining in clinical remission among patients on combination therapy with specialised enteral nutrition and Infliximab (IFX) compared with IFX monotherapy (OR 2.73; 95% CI: 1.73–4.31, p < 0.01, OR 2.93; 95% CI: 1.66–5.17, p < 0.01, respectively). In conclusion, evidence-based knowledge on impact of diet on anti-TNF treatment response for clinical use is scarce. Here we propose a mechanism by which Western style diet high in meat and low in fibre may promote colonic inflammation and potentially impact treatment response to anti-TNF drugs. Further studies using hypothesis-driven and data-driven strategies in prospective observational, animal and interventional studies are warranted.

KW - Anti-TNF

KW - Chronic inflammatory diseases

KW - Diet

KW - Dietary pattern

KW - Epithelium-associated bacteria

KW - Fibre intake

KW - Food

KW - Lifestyle factors

KW - Meat intake

KW - Microbiome

KW - Mucin-degrading bacteria

KW - Mucosa associated bacteria

KW - Mucus

KW - Personalized medicine

KW - Sulphate-reducing bacteria

KW - Treatment response

KW - Treatment result

KW - Western style diet

U2 - 10.3390/nu9030286

DO - 10.3390/nu9030286

M3 - Review

C2 - 28294972

AN - SCOPUS:85015682944

SN - 2072-6643

VL - 9

JO - Nutrients

JF - Nutrients

IS - 3

M1 - 286

ER -