P005 Overcoming secondary loss of response to infliximab in patients with ulcerative colitis with the use of mesenchymal stromal cells

P005
Overcoming secondary loss of response to infliximab in patients with ulcerative colitis with the use of mesenchymal stromal cells
 

Knyazev Oleg1, Lishchinskaya Albina1, Konoplyannikov Anatoliy2, Kagramanova Anna1, Fadeeva Nina, Kulakov Dmitriy1, Babayan Anait1, Zvyaglova Mariya1, Parfenov Asfold
1 Moscow Clinical Scientific Center named after A. S. Loginov, Moscow, Russia, 2 2Medical Radiological Research Center named after A.F Tsyb, Obninsk, Russia

BACKGROUND: Long-term experience with infliximab (IFX) shows that within a year, 20-30% of patients with ulcerative colitis (UC) develop acquired drug resistance (secondary inefficiency).
Aim: To establish the possibility of overcoming the secondary inefficiency of IFX in UC patients using mesenchymal stromal cells (MSCS).

METHODS: In the IBD treatment department, the clinical status of 84 UC patients receiving IFX therapy was evaluated. Secondary loss of response was registered in 28 UC patients, which required optimization of IFX therapy. Twelve patients (group 1), in order to overcome the secondary loss of response, were administered MSCS three times every 4 weeks. 16 patients with UC (group 2) received standard optimized IFX therapy. The effectiveness of therapy was evaluated after 12 weeks of therapy (reduction of the Mayo score) and normalization of laboratory parameters (erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), hemoglobin, fecal calprotectin (FCP). The comparative analysis was carried out using the method of four-field tables using nonparametric statistical criteria.

RESULTS: In 10 (83.3%) of 12 patients of group 1, a significant positive dynamic was observed after 12 weeks: a decrease in the Mayo index and normalization of laboratory parameters (ESR, CRP, hemoglobin, FCP). In 4 (25.0%) patients with UC from group 2, against the background of optimized IFX therapy, a significant positive dynamic was also observed with a decrease in the Mayo index and an improvement in ESR, CRP, hemoglobin and FCP levels. However, 12 patients from group 2 were transferred to therapy with other anti-TNF-α drugs and drugs with a different mechanism of action (HR-0.222, 95% CI 0.061-0.812; x2 - 7.146; p=0.00334).

CONCLUSION(S): The use of mesenchymal stromal cells of the bone marrow helps to overcome the secondary loss of response to infliximab in patients with ulcerative colitis.