Casanova, M JChaparro, MGarcia-Sanchez, VNantes, OLeo, ERojas-Feria, MJauregui-Amezaga, AGarcia-Lopez, SHuguet, J MArguelles-Arias, FAicart, MMarin-Jimenez, IGomez-Garcia, MMuñoz, FEsteve, MBujanda, LCortes, XTosca, JPineda, J RMañosa, MLlao, JGuardiola, JPerez-Martinez, IMuñoz, CGonzalez-Lama, YHinojosa, JVazquez, J MMartinez-Montiel, M PRodriguez, G EPajares, RGarcia-Sepulcre, M FHernandez-Martinez, APerez-Calle, J LBeltran, BBusquets, DRamos, LBermejo, FBarrio, JBarreiro-de Acosta, MRoncedo, OCalvet, XHervias, DGomollon, FDominguez-Antonaya, MAlcain, GSicilia, BDueñas, CGutierrez, ALorente-Poyatos, RDominguez, MKhorrami, SMuñoz, CTaxonera, CRodriguez-Perez, APonferrada, AVan Domselaar, MArias-Rivera, M LMerino, OCastro, EMarrero, J MMartin-Arranz, MBotella, BFernandez-Salazar, LMonfort, DOpio, VGarcia-Herola, AMenacho, MRamirez-de la Piscina, PCeballos, DAlmela, PNavarro-Llavat, MRobles-Alonso, VVega-Lopez, A BMoraleja, INovella, M TCastaño-Milla, CSanchez-Torres, ABenitez, J MRodriguez, CCastro, LGarrido, EDomenech, EGarcia-Planella, EGisbert, J P2023-01-252023-01-252017Casanova MJ, Chaparro M, García-Sánchez V, Nantes O, Leo E, Rojas-Feria M, et al. Evolution After Anti-TNF Discontinuation in Patients With Inflammatory Bowel Disease: A Multicenter Long-Term Follow-Up Study. Am J Gastroenterol. 2017 Jan;112(1):120-131http://hdl.handle.net/10668/10674The 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.enAntirheumatic AgentsColitis, UlcerativeConstriction, PathologicCrohn DiseaseDeprescriptionsDisease ProgressionAdalimumabAdolescentAdultAge FactorsAgedAged, 80 and overDrug-Related Side Effects and Adverse ReactionsFemaleFollow-Up StudiesHumansIleumImmunologic FactorsIncidenceInflammatory Bowel DiseasesInfliximabMaleMesalamineMethotrexateMiddle AgedProportional Hazards ModelsProtective FactorsRecurrenceRemission InductionRetreatmentRetrospective StudiesRisk FactorsTumor Necrosis Factor-alphaYoung Adultresearch article27958281Restricted AccessEnfermedades inflamatorias del intestinoEnfermedad de CrohnColitis ulcerosaFactor de necrosis tumoral alfaInhibidores del factor de necrosis tumoralRecaída10.1038/ajg.2016.5691572-0241https://zaguan.unizar.es/record/79368/files/texto_completo.pdf