Clinical outcome after anti-tumour necrosis factor therapy discontinuation in 1000 patients with inflammatory bowel disease: the EVODIS long-term study

被引:18
作者
Casanova, Maria Jose [1 ,2 ]
Chaparro, Maria [1 ,2 ]
Nantes, Oscar [3 ]
Benitez, Jose Manuel [4 ]
Rojas-Feria, Maria [5 ,6 ]
Castro-Poceiro, Jesus [7 ,8 ]
Huguet, Jose Maria [9 ]
Martin-Cardona, Albert [10 ,11 ]
Aicart-Ramos, Marta [12 ]
Tosca, Joan [13 ,14 ]
Martin-Rodriguez, Maria del Mar [15 ]
Gonzalez-Munoza, Carlos [16 ]
Manosa, Miriam [17 ,18 ]
Leo-Carnerero, Eduardo [19 ]
Lamuela-Calvo, Luis Javier [20 ,21 ]
Perez-Martinez, Isabel [22 ]
Bujanda, Luis [23 ,24 ]
Hinojosa, Joaquin [25 ]
Pajares, Ramon [26 ]
Arguelles-Arias, Federico [27 ]
Perez-Calle, Jose Lazaro [28 ]
Rodriguez-Gonzalez, Gloria Esther [29 ]
Guardiola, Jordi [30 ]
Barreiro-de Acosta, Manuel [31 ]
Gisbert, Javier P. [1 ,2 ]
机构
[1] Univ Autonoma Madrid UAM, Inst Invest Sanitaria Princesa IIS IP, Hosp Univ La Princesa, Madrid, Spain
[2] Ctr Invest Biomed Red Enfermedades Hepat & Digest, Madrid, Spain
[3] Complejo Hosp Navarra, Inst Invest Sanitaria Navarra IdiSNA, Pamplona, Spain
[4] Hosp Univ Reina Sofia, Inst Maimonides Invest Biomed Cordoba IMIBIC, Cordoba, Spain
[5] Hosp Univ Valme, Seville, Spain
[6] CIBEREHD, Seville, Spain
[7] Hosp Clin Barcelona, IDIBAPS, Barcelona, Spain
[8] CIBEREHD, Barcelona, Spain
[9] Consorcio Hosp Gen Univ Valencia, Valencia, Spain
[10] Hosp Univ Mutua Terrassa, Terrassa, Spain
[11] CIBEREHD, Terrassa, Spain
[12] Hosp Univ Ramon y Cajal, Madrid, Spain
[13] Hosp Clin Valencia, Valencia, Spain
[14] Univ Valencia, Valencia, Spain
[15] Hosp Univ Virgen Nieves, Granada, Spain
[16] Hosp Santa Creu & Sant Pau, Barcelona, Spain
[17] Hosp Badalona Germans Trias & Pujol, Badalona, Spain
[18] CIBEREHD, Badalona, Spain
[19] Hosp Univ Virgen Rocio, Seville, Spain
[20] Hosp Univ Miguel Servet, Zaragoza, Spain
[21] Inst Invest Sanitaria Aragon IIS Aragon, Zaragoza, Spain
[22] Hosp Univ Cent Asturias, Oviedo, Spain
[23] Univ Pais Vasco UPV EHU, Inst Biodonostia, Hosp Univ Donostia, Donostia San Sebastian, Spain
[24] CIBEREHD, Donostia San Sebastian, Spain
[25] Hosp Manises, Valencia, Spain
[26] Hosp Univ Infanta Sofia, Madrid, Spain
[27] Hosp Univ Virgen Macarena, Seville, Spain
[28] Hosp Univ Fdn Alcorcon, Madrid, Spain
[29] Hosp Univ Nuestra Senora Candelaria, Santa Cruz De Tenerife, Spain
[30] Hosp Univ Bellvitge, Barcelona, Spain
[31] Hosp Clin Univ Santiago de Compostela, Santiago De Compostela, Spain
关键词
ANTI-TNF DISCONTINUATION; CROHNS-DISEASE; ANTIMETABOLITE THERAPY; INFLIXIMAB THERAPY; REMISSION; MAINTENANCE; RELAPSE; WITHDRAWAL;
D O I
10.1111/apt.16361
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
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.
引用
收藏
页码:1277 / 1288
页数:12
相关论文
共 24 条
[1]   Relapse after withdrawal from anti-TNF therapy for inflammatory bowel disease: an observational study, plus systematic review and meta-analysis [J].
Ahmad, Tariq ;
Basavaraju, Umesh ;
Basquill, Catriona ;
Cameron, Fiona L. ;
Christodoulou, Christos ;
Cummings, Fraser ;
Ding, Nik S. ;
Fadra, Adam S. ;
Flanders, Lucy ;
Gaya, Daniel R. ;
Gooding, Ian ;
Gordon, John ;
Grieveson, Kay ;
Harris, Richard ;
Hart, Ailsa ;
Hendy, Philip ;
Irving, Peter ;
Johnston, Emma L. ;
Johnston, Matthew ;
Kennedy, Nicholas A. ;
Lal, Simon ;
Lamb, Christopher A. ;
Lees, Charlie W. ;
Lindsay, James O. ;
Lithgo, Karen ;
Lockett, Melanie ;
Maggs, Daniel ;
Mann, Steve ;
Mansfield, John ;
Mason, Joy ;
McCartney, Sara ;
Murray, Charles D. ;
Nowell, Emma ;
Parkes, Miles ;
Russell, Richard K. ;
Satsangi, Jack ;
Singh, Abhey ;
Stansfield, Catherine ;
Thomson, John ;
Warner, Ben ;
Wilson, David C. .
ALIMENTARY PHARMACOLOGY & THERAPEUTICS, 2016, 43 (08) :910-923
[2]  
[Anonymous], 2015, J CROHNS COLITIS
[3]   Undetectable anti-TNF drug levels in patients with long-term remission predict successful drug withdrawal [J].
Ben-Horin, S. ;
Chowers, Y. ;
Ungar, B. ;
Kopylov, U. ;
Loebstein, R. ;
Weiss, B. ;
Eliakim, R. ;
Del Tedesco, E. ;
Paul, S. ;
Roblin, X. .
ALIMENTARY PHARMACOLOGY & THERAPEUTICS, 2015, 42 (03) :356-364
[4]  
Ben-Horin S, 2018, J CLIN GASTROENTEROL, V52, P6, DOI [10.1097/MCG.0000000000000762, 10.1097/MCG.0000000000000938]
[5]   Relapse rates and predictors for relapse in a real-life cohort of IBD patients after discontinuation of anti-TNF therapy [J].
Bots, Steven J. ;
Kuin, Sabine ;
Ponsioen, Cyriel Y. ;
Gecse, Krisztina B. ;
Duijvestein, Marjolijn ;
D'Haens, Geert R. ;
Lowenberg, Mark .
SCANDINAVIAN JOURNAL OF GASTROENTEROLOGY, 2019, 54 (03) :281-288
[6]   Evolution After Anti-TNF Discontinuation in Patients With Inflammatory Bowel Disease: A Multicenter Long-Term Follow-Up Study [J].
Casanova, M. J. ;
Chaparro, M. ;
Garcia-Sanchez, V. ;
Nantes, O. ;
Leo, E. ;
Rojas-Feria, M. ;
Jauregui-Amezaga, A. ;
Garcia-Lopez, S. ;
Huguet, J. M. ;
Arguelles-Arias, F. ;
Aicart, M. ;
Marin-Jimenez, I. ;
Gomez-Garcia, M. ;
Munoz, F. ;
Esteve, M. ;
Bujanda, L. ;
Cortes, X. ;
Tosca, J. ;
Pineda, J. R. ;
Manosa, M. ;
Llao, J. ;
Guardiola, J. ;
Perez-Martinez, I. ;
Munoz, C. ;
Gonzalez-Lama, Y. ;
Hinojosa, J. ;
Vazquez, J. M. ;
Martinez-Montiel, M. P. ;
Rodriguez, G. E. ;
Pajares, R. ;
Garcia-Sepulcre, M. F. ;
Hernandez-Martinez, A. ;
Perez-Calle, J. L. ;
Beltran, B. ;
Busquets, D. ;
Ramos, L. ;
Bermejo, F. ;
Barrio, J. ;
Barreiro-de Acosta, M. ;
Roncedo, O. ;
Calvet, X. ;
Hervias, D. ;
Gomollon, F. ;
Dominguez-Antonaya, M. ;
Alcain, G. ;
Sicilia, B. ;
Duenas, C. ;
Gutierrez, A. ;
Lorente-Poyatos, R. ;
Dominguez, M. .
AMERICAN JOURNAL OF GASTROENTEROLOGY, 2017, 112 (01) :120-131
[7]   Infliximab as a bridge to remission maintained by antimetabolite therapy in Crohn's disease: A retrospective study [J].
Chauvin, Armelle ;
Le Thuaut, Aurelie ;
Belhassan, Mehdi ;
Le Baleur, Yann ;
Mesli, Farida ;
Bastuji-Garin, Sylvie ;
Delchier, Jean Charles ;
Amiot, Aurelien .
DIGESTIVE AND LIVER DISEASE, 2014, 46 (08) :695-700
[8]   Challenges to the Design, Execution, and Analysis of Randomized Controlled Trials for Inflammatory Bowel Disease [J].
D'Haens, Geert ;
Feagan, Brian ;
Colombel, Jean-Frederic ;
Sandborn, William J. ;
Reinisch, Walter ;
Rutgeerts, Paul ;
Carbonnel, Frank ;
Mary, Jean-Yves ;
Danese, Silvio ;
Fedorak, Richard N. ;
Hanauer, Steven ;
Lemann, Marc .
GASTROENTEROLOGY, 2012, 143 (06) :1461-1469
[9]   European Crohn's and Colitis Organisation Topical Review on Treatment Withdrawal ['Exit Strategies'] in Inflammatory Bowel Disease [J].
Doherty, Glen ;
Katsanos, Konstantinos H. ;
Burisch, Johan ;
Allez, Matthieu ;
Papamichael, Konstantinos ;
Stallmach, Andreas ;
Mao, Ren ;
Berset, Ingrid Prytz ;
Gisbert, Javier P. ;
Sebastian, Shaji ;
Kierkus, Jaroslaw ;
Lopetuso, Loris ;
Szymanska, Edyta ;
Louis, Edouard .
JOURNAL OF CROHNS & COLITIS, 2018, 12 (01) :17-31
[10]   Systematic review: factors associated with relapse of inflammatory bowel disease after discontinuation of anti-TNF therapy [J].
Gisbert, J. P. ;
Marin, A. C. ;
Chaparro, M. .
ALIMENTARY PHARMACOLOGY & THERAPEUTICS, 2015, 42 (04) :391-405