%0 Journal Article
%A Casanova, M J
%A Chaparro, M
%A Garcia-Sanchez, V
%A Nantes, O
%A Leo, E
%A Rojas-Feria, M
%A Jauregui-Amezaga, A
%A Garcia-Lopez, S
%A Huguet, J M
%A Arguelles-Arias, F
%A Aicart, M
%A Marin-Jimenez, I
%A Gomez-Garcia, M
%A Muñoz, F
%A Esteve, M
%A Bujanda, L
%A Cortes, X
%A Tosca, J
%A Pineda, J R
%A Mañosa, M
%A Llao, J
%A Guardiola, J
%A Perez-Martinez, I
%A Muñoz, C
%A Gonzalez-Lama, Y
%A Hinojosa, J
%A Vazquez, J M
%A Martinez-Montiel, M P
%A Rodriguez, G E
%A Pajares, R
%A Garcia-Sepulcre, M F
%A Hernandez-Martinez, A
%A Perez-Calle, J L
%A Beltran, B
%A Busquets, D
%A Ramos, L
%A Bermejo, F
%A Barrio, J
%A Barreiro-de Acosta, M
%A Roncedo, O
%A Calvet, X
%A Hervias, D
%A Gomollon, F
%A Dominguez-Antonaya, M
%A Alcain, G
%A Sicilia, B
%A Dueñas, C
%A Gutierrez, A
%A Lorente-Poyatos, R
%A Dominguez, M
%A Khorrami, S
%A Muñoz, C
%A Taxonera, C
%A Rodriguez-Perez, A
%A Ponferrada, A
%A Van Domselaar, M
%A Arias-Rivera, M L
%A Merino, O
%A Castro, E
%A Marrero, J M
%A Martin-Arranz, M
%A Botella, B
%A Fernandez-Salazar, L
%A Monfort, D
%A Opio, V
%A Garcia-Herola, A
%A Menacho, M
%A Ramirez-de la Piscina, P
%A Ceballos, D
%A Almela, P
%A Navarro-Llavat, M
%A Robles-Alonso, V
%A Vega-Lopez, A B
%A Moraleja, I
%A Novella, M T
%A Castaño-Milla, C
%A Sanchez-Torres, A
%A Benitez, J M
%A Rodriguez, C
%A Castro, L
%A Garrido, E
%A Domenech, E
%A Garcia-Planella, E
%A Gisbert, J P
%T Evolution After Anti-TNF Discontinuation in Patients With Inflammatory Bowel Disease: A Multicenter Long-Term Follow-Up Study.
%D 2017
%U http://hdl.handle.net/10668/10674
%X The aims of this study were to assess the risk of relapse after discontinuation of anti-tumor necrosis factor (anti-TNF) drugs in patients with inflammatory bowel disease (IBD), to identify the factors associated with relapse, and to evaluate the overcome after retreatment with the same anti-TNF in those who relapsed. This was a retrospective, observational, multicenter study. IBD patients who had been treated with anti-TNFs and in whom these drugs were discontinued after clinical remission was achieved were included. A total of 1,055 patients were included. The incidence rate of relapse was 19% and 17% per patient-year in Crohn's disease and ulcerative colitis patients, respectively. In both Crohn's disease and ulcerative colitis patients in deep remission, the incidence rate of relapse was 19% per patient-year. The treatment with adalimumab vs. infliximab (hazard ratio (HR)=1.29; 95% confidence interval (CI)=1.01-1.66), elective discontinuation of anti-TNFs (HR=1.90; 95% CI=1.07-3.37) or discontinuation because of adverse events (HR=2.33; 95% CI=1.27-2.02) vs. a top-down strategy, colonic localization (HR=1.51; 95% CI=1.13-2.02) vs. ileal, and stricturing behavior (HR=1.5; 95% CI=1.09-2.05) vs. inflammatory were associated with a higher risk of relapse in Crohn's disease patients, whereas treatment with immunomodulators after discontinuation (HR=0.67; 95% CI=0.51-0.87) and age (HR=0.98; 95% CI=0.97-0.99) were protective factors. None of the factors were predictive in ulcerative colitis patients. Retreatment of relapse with the same anti-TNF was effective (80% responded) and safe. The incidence rate of inflammatory bowel disease relapse after anti-TNF discontinuation is relevant. Some predictive factors of relapse after anti-TNF withdrawal have been identified. Retreatment with the same anti-TNF drug was effective and safe.
%K Antirheumatic Agents
%K Colitis, Ulcerative
%K Constriction, Pathologic
%K Crohn Disease
%K Deprescriptions
%K Disease Progression
%~