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 19 October 2017

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News

Anti-TNF discontinuation in patients with inflammatory bowel disease

This month's American Journal of Gastroenterology assesses the risk of relapse after discontinuation of anti-tumor necrosis factor drugs in patients with inflammatory bowel disease.

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Dr Casanova and colleagues from Spain assessed the risk of relapse after discontinuation of anti-tumor necrosis factor (anti-TNF) drugs in patients with inflammatory bowel disease (IBD).

The team identified the factors associated with relapse, and evaluated the overcome after retreatment with the same anti-TNF in those who relapsed.

The researchers performed 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. 

In both Crohn’s and ulcerative colitis patients in deep remission, the incidence rate of relapse was 19% per patient-year
American Journal of Gastroenterology
The researchers found that 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, elective discontinuation of anti-TNFs or discontinuation because of adverse events vs. a top-down strategy, colonic localization vs. ileal, and stricturing behavior vs. inflammatory were associated with a higher risk of relapse in Crohn’s disease patients.

The researchers found that treatment with immunomodulators after discontinuation and age were protective factors. 

None of the factors were predictive in ulcerative colitis patients. 

The researchers found that retreatment of relapse with the same anti-TNF was effective and safe.

Dr Casanova's team concludes, "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."

Am J Gastroenterol 2017; 112:120–131
13 January 2017

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