RT Journal Article
T1 Evolution After Anti-TNF Discontinuation in Patients With Inflammatory Bowel Disease: A Multicenter Long-Term Follow-Up Study.
A1 Casanova, M J
A1 Chaparro, M
A1 García-Sánchez, V
A1 Nantes, O
A1 Leo, E
A1 Rojas-Feria, M
A1 Jauregui-Amezaga, A
A1 García-López, S
A1 Huguet, J M
A1 Arguelles-Arias, F
A1 Aicart, M
A1 Marín-Jiménez, I
A1 Gómez-García, M
A1 Muñoz, F
A1 Esteve, M
A1 Bujanda, L
A1 Cortés, X
A1 Tosca, J
A1 Pineda, J R
A1 Mañosa, M
A1 Llaó, J
A1 Guardiola, J
A1 Pérez-Martínez, I
A1 Muñoz, C
A1 González-Lama, Y
A1 Hinojosa, J
A1 Vázquez, J M
A1 Martinez-Montiel, M P
A1 Rodríguez, G E
A1 Pajares, R
A1 García-Sepulcre, M F
A1 Hernández-Martínez, A
A1 Pérez-Calle, J L
A1 Beltrán, B
A1 Busquets, D
A1 Ramos, L
A1 Bermejo, F
A1 Barrio, J
A1 Barreiro-de Acosta, M
A1 Roncedo, O
A1 Calvet, X
A1 Hervías, D
A1 Gomollón, F
A1 Domínguez-Antonaya, M
A1 Alcaín, G
A1 Sicilia, B
A1 Dueñas, C
A1 Gutiérrez, A
A1 Lorente-Poyatos, R
A1 Domínguez, M
A1 Khorrami, S
A1 Muñoz, C
A1 Taxonera, C
A1 Rodríguez-Pérez, A
A1 Ponferrada, A
A1 Van Domselaar, M
A1 Arias-Rivera, M L
A1 Merino, O
A1 Castro, E
A1 Marrero, J M
A1 Martín-Arranz, M
A1 Botella, B
A1 Fernández-Salazar, L
A1 Monfort, D
A1 Opio, V
A1 García-Herola, A
A1 Menacho, M
A1 Ramírez-de la Piscina, P
A1 Ceballos, D
A1 Almela, P
A1 Navarro-Llavat, M
A1 Robles-Alonso, V
A1 Vega-López, A B
A1 Moraleja, I
A1 Novella, M T
A1 Castaño-Milla, C
A1 Sánchez-Torres, A
A1 Benítez, J M
A1 Rodríguez, C
A1 Castro, L
A1 Garrido, E
A1 Domènech, E
A1 García-Planella, E
A1 Gisbert, J P
AB 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.
YR 2016
FD 2016-12-13
LK http://hdl.handle.net/10668/10674
UL http://hdl.handle.net/10668/10674
LA en
DS RISalud
RD Apr 20, 2025