Evolution after Anti-TNF Discontinuation in Patients with Inflammatory Bowel Disease: A Multicenter Long-Term Follow-Up Study

Casanova, M. J.; Benítez, J. M.; Ramirez de la Piscina, P.; García-Sepulcre, M. F.; Bujanda, L.; Garrido, E.; Almela, P.; Sánchez-Torres, A.; Vega-López, A. B.; Leo, E.; Domínguez-Antonaya, M.; Sicilia, B.; Mañosa, M.; Nantes, O.; Esteve, M.; Cortés, X.; Bermejo, F.; Dueñas, C.; Ceballos, D.; Taxonera, C.; Botella, B.; Rodríguez, C.; Navarro-Llavat, M.; Khorrami, S.; Martinez-Montiel, M.; Vázquez, J. M.; Gutiérrez, A.; Muñoz, F.; Rojas-Feria, M.; Hernández-Martínez, A.; Roncedo, O.; Guardiola, J.; Opio, V.; Pérez-Calle, J. L.; Arguelles-Arias, F.; Gómez-García, M.; Novella, M. T.; Ponferrada, A.; Llaó, J.; Tosca, J.; Muñoz, C.; Beltrán, B.; Barreiro-De Acosta, M.; Merino, O.; Marín-Jiménez, I.; Aicart, M.; Pineda, J. R.; Castro, E.; Moraleja, I.; Castro, L.; Chaparro, M.; Pérez-Martínez, I.; Alcaín, G.; Ramos, L.; Gomollón, F.; García-Sánchez, V.; Lorente-Poyatos, R.; Domènech, E.; Monfort, D.; García-Herola, A.; Menacho, M.; Robles-Alonso, V.; González-Lama, Y.; Arias-Rivera, M.; Domínguez, M.; Hervías, D.; García-Planella, E.; Rodríguez-Pérez, A.; Castaño-Milla, C.; Calvet, X.; Martín-Arranz, M.; Pajares, R.; Busquets, D.; Huguet, J. M.; Van Domselaar, M.; Barrio, J.; García-López, S.; Gisbert, J. P.; Fernández-Salazar, L.; Marrero, J. M.; Hinojosa, J.; Jauregui-Amezaga, A.; Rodríguez, G. E.

doi:10.1038/ajg.2016.569

000079368 001__ 79368
000079368 005__ 20190709135734.0
000079368 0247_ $$2doi$$a10.1038/ajg.2016.569
000079368 0248_ $$2sideral$$a97845
000079368 037__ $$aART-2017-97845
000079368 041__ $$aeng
000079368 100__ $$aCasanova, M. J.
000079368 245__ $$aEvolution after Anti-TNF Discontinuation in Patients with Inflammatory Bowel Disease: A Multicenter Long-Term Follow-Up Study
000079368 260__ $$c2017
000079368 5060_ $$aAccess copy available to the general public$$fUnrestricted
000079368 5203_ $$aOBJECTIVES: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.METHODS: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.RESULTS: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.CONCLUSIONS: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.
000079368 540__ $$9info:eu-repo/semantics/openAccess$$aAll rights reserved$$uhttp://www.europeana.eu/rights/rr-f/
000079368 590__ $$a10.231$$b2017
000079368 591__ $$aGASTROENTEROLOGY & HEPATOLOGY$$b6 / 80 = 0.075$$c2017$$dQ1$$eT1
000079368 592__ $$a4.197$$b2017
000079368 593__ $$aHepatology$$c2017$$dQ1
000079368 593__ $$aGastroenterology$$c2017$$dQ1
000079368 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/acceptedVersion
000079368 700__ $$aChaparro, M.
000079368 700__ $$aGarcía-Sánchez, V.
000079368 700__ $$aNantes, O.
000079368 700__ $$aLeo, E.
000079368 700__ $$aRojas-Feria, M.
000079368 700__ $$aJauregui-Amezaga, A.
000079368 700__ $$0(orcid)0000-0003-3970-5457$$aGarcía-López, S.$$uUniversidad de Zaragoza
000079368 700__ $$aHuguet, J. M.
000079368 700__ $$aArguelles-Arias, F.
000079368 700__ $$aAicart, M.
000079368 700__ $$aMarín-Jiménez, I.
000079368 700__ $$aGómez-García, M.
000079368 700__ $$aMuñoz, F.
000079368 700__ $$aEsteve, M.
000079368 700__ $$aBujanda, L.
000079368 700__ $$aCortés, X.
000079368 700__ $$aTosca, J.
000079368 700__ $$aPineda, J. R.
000079368 700__ $$aMañosa, M.
000079368 700__ $$aLlaó, J.
000079368 700__ $$aGuardiola, J.
000079368 700__ $$aPérez-Martínez, I.
000079368 700__ $$aMuñoz, C.
000079368 700__ $$aGonzález-Lama, Y.
000079368 700__ $$aHinojosa, J.
000079368 700__ $$aVázquez, J. M.
000079368 700__ $$aMartinez-Montiel, M.
000079368 700__ $$aRodríguez, G. E.
000079368 700__ $$aPajares, R.
000079368 700__ $$aGarcía-Sepulcre, M. F.
000079368 700__ $$aHernández-Martínez, A.
000079368 700__ $$aPérez-Calle, J. L.
000079368 700__ $$aBeltrán, B.
000079368 700__ $$aBusquets, D.
000079368 700__ $$aRamos, L.
000079368 700__ $$aBermejo, F.
000079368 700__ $$aBarrio, J.
000079368 700__ $$aBarreiro-De Acosta, M.
000079368 700__ $$aRoncedo, O.
000079368 700__ $$aCalvet, X.
000079368 700__ $$aHervías, D.
000079368 700__ $$0(orcid)0000-0003-0076-3529$$aGomollón, F.$$uUniversidad de Zaragoza
000079368 700__ $$aDomínguez-Antonaya, M.
000079368 700__ $$aAlcaín, G.
000079368 700__ $$aSicilia, B.
000079368 700__ $$aDueñas, C.
000079368 700__ $$aGutiérrez, A.
000079368 700__ $$aLorente-Poyatos, R.
000079368 700__ $$aDomínguez, M.
000079368 700__ $$aKhorrami, S.
000079368 700__ $$aMuñoz, C.
000079368 700__ $$aTaxonera, C.
000079368 700__ $$aRodríguez-Pérez, A.
000079368 700__ $$aPonferrada, A.
000079368 700__ $$aVan Domselaar, M.
000079368 700__ $$aArias-Rivera, M.
000079368 700__ $$aMerino, O.
000079368 700__ $$aCastro, E.
000079368 700__ $$aMarrero, J. M.
000079368 700__ $$aMartín-Arranz, M.
000079368 700__ $$aBotella, B.
000079368 700__ $$aFernández-Salazar, L.
000079368 700__ $$aMonfort, D.
000079368 700__ $$aOpio, V.
000079368 700__ $$aGarcía-Herola, A.
000079368 700__ $$aMenacho, M.
000079368 700__ $$aRamirez de la Piscina, P.
000079368 700__ $$aCeballos, D.
000079368 700__ $$aAlmela, P.
000079368 700__ $$aNavarro-Llavat, M.
000079368 700__ $$aRobles-Alonso, V.
000079368 700__ $$aVega-López, A. B.
000079368 700__ $$aMoraleja, I.
000079368 700__ $$aNovella, M. T.
000079368 700__ $$aCastaño-Milla, C.
000079368 700__ $$aSánchez-Torres, A.
000079368 700__ $$aBenítez, J. M.
000079368 700__ $$aRodríguez, C.
000079368 700__ $$aCastro, L.
000079368 700__ $$aGarrido, E.
000079368 700__ $$aDomènech, E.
000079368 700__ $$aGarcía-Planella, E.
000079368 700__ $$aGisbert, J. P.
000079368 7102_ $$11007$$2610$$aUniversidad de Zaragoza$$bDpto. Medicina, Psiqu. y Derm.$$cArea Medicina
000079368 773__ $$g112, 1 (2017), 120-131$$pAm. j. gastroenterol.$$tAmerican Journal of Gastroenterology$$x0002-9270
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000079368 951__ $$a2019-07-09-13:08:55
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