1. Clinical outcome after anti‐tumour necrosis factor therapy discontinuation in 1000 patients with inflammatory bowel disease: the EVODIS long‐term study
- Author
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Luis Javier Lamuela‐Calvo, Marta Aicart‐Ramos, Joaquín Hinojosa, José Manuel Benítez, M Rojas-Feria, María del Mar Martín‐Rodríguez, Míriam Mañosa, Eduardo Leo-Carnerero, Óscar Nantes, José Lázaro Pérez-Calle, María José Casanova, Luis Bujanda, Joan Tosca, Manuel Barreiro-de Acosta, Jordi Guardiola, Gloria Esther Rodríguez‐González, Isabel Pérez-Martínez, Jesús Castro-Poceiro, A Martín-Cardona, José María Huguet, Javier P. Gisbert, María Chaparro, R. Pajares, Federico Argüelles-Arias, and C González-Muñoza
- Subjects
medicine.medical_specialty ,Hepatology ,business.industry ,Gastroenterology ,Retrospective cohort study ,medicine.disease ,Ulcerative colitis ,Inflammatory bowel disease ,Confidence interval ,Discontinuation ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Cohort ,Medicine ,030211 gastroenterology & hepatology ,Pharmacology (medical) ,Cumulative incidence ,030212 general & internal medicine ,Colitis ,business - Abstract
Background The long-term outcome of patients after antitumour necrosis factor alpha (anti-TNF) discontinuation is not well known. Aims To assess the risk of relapse in the long-term after anti-TNF discontinuation. Methods This was an extension of the evolution after anti-TNF discontinuation in patients with inflammatory bowel disease (EVODIS) study (Crohn's disease or ulcerative colitis patients treated with anti-TNFs in whom these drugs were withdrawn after achieving clinical remission) based in the same cohort of patients whose outcome was updated. Clinical remission was defined as a Harvey-Bradshaw index ≤4 points in Crohn's disease, a partial Mayo score ≤2 in ulcerative colitis and the absence of fistula drainage despite gentle finger compression in perianal disease. Results This was an observational, retrospective, multicenter study. A total of 1055 patients were included. The median follow-up time was 34 months. The incidence rate of relapse was 12% per patient-year (95% confidence interval [CI] = 11-14). The cumulative incidence of relapse was 50% (95% CI = 47-53): 19% at one year, 31% at 2 years, 38% at 3 years, 44% at 4 years and 48% at 5 years of follow-up. Of the 60% patients retreated with the same anti-TNF after relapse, 73% regained remission. Of the 75 patients who did not respond, 48% achieved remission with other therapies. Of the 190 patients who started other therapies after relapse, 62% achieved remission with the new treatment. Conclusions A significant proportion of patients who discontinued the anti-TNF remained in remission. In case of relapse, retreatment with the same anti-TNF was usually effective. Approximately half of the patients who did not respond after retreatment achieved remission with other therapies.
- Published
- 2021
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