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Predictors of relapse in Crohn's disease after biological therapy

The Alimentary Pharmacology & Therapeutics identifies predictors of relapse in patients with Crohn's disease in remission after 1 year of biological therapy.

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Some of the most important questions relating to the use of biological therapy in inflammatory bowel diseases concern the duration of maintenance therapy.
 
Dr Molnár and colleagues from Hungary assessed the disease course and frequency of relapse of Crohn's disease (CD) following discontinuation of biological therapy, and determined predictive factors for relapse.
 
There were 121 Crohn's disease patients who had achieved clinical remission following 1 year of biological therapy, and for whom biological therapy was then discontinued, who participated in this prospective observational study.

The research team reported that 87 Crohn's disease patients had received infliximab, and 34 adalimumab.

Smoking had an effect that was not statistically significant
Alimentary Pharmacology & Therapeutics

The definition of relapse was an increase of more than 100 points in CDAI to at least a CDAI of 150 points.
 
Biological therapy was restarted within 1 year of treatment cessation in 45% of patients.

The researchers showed that previous biological therapy, and dose intensification during the 1-year course of biological therapy were associated with the need for and the time to the restarting of biological therapy.

The team observed that smoking had an effect that was not statistically significant.
 
Dr Molnár's team concludes, "Biological therapy was restarted a median of 6 months after discontinuation in almost half of Crohn's disease patients in who had been in clinical remission following 1 year of biological therapy."

"These results suggest that, in the event of the presence of certain predictive factors, biological therapy should probably be continued for more than 1 year by most patients."

Aliment Pharmacol Ther 2012: DOI: 10.1111/apt.12160
29 November 2012

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