P544 Low TNF production and low TREM1 expression as negative predictors for remission under adalimumab therapy in Crohn′s Disease patients

Abstract Background Approximately one third of IBD patients show a primary non-response to anti-TNF therapy. An individualized treatment approach requires clinical predictors. Our previous study showed that LPS-stimulated TNF production can be used predict response infliximab in Crohn′s Disease patients. The expression the myeloid receptor TREM1 is also known as potential predictive marker for therapy response. aim this compare these two predictors adalimumab. Methods In prospective observational 24 adults with starting adalimumab were included. activity was assessed clinically (Harvey-Bradshaw-Index (HBI)), through lab results (leukocytes, C-reactive protein, calprotectin) and per ultrasound (Limberg-Score) at time point induction, after 6 12 weeks. TNF-production peripheral blood mononuclear cells measured via ELISA baseline. its soluble isoform TREM1sv quantified from whole RNA qPCR. Primary endpoints week 12. Response defined decrease HBI ≥2, remission <5. Cut-off values low- high-producers receiver operating characteristic (ROC). Results tested significance chi²-Test. Of recruited 18 have currently reached 5 not within weeks, 4 differed among After definition cut-off value low-TNF-producers, 8 low-TREM1-producers 7 low-TREM1sv-producers could identified. Three out low-TNF-producers non-remission weeks compared 2 high-TNF-producers (p=0.1366). Five 0 9 high-TREM1-producers (p=0.0048, 1 missing value). Four 10 high-TREM1sv-producers (p=0.0488, Figure 1) Remission - low vs. high 2) 3) Conclusion Low seem stronger TNF-production. These are validated increased patient numbers.