Relapse Risk After Anti-TNF Discontinuation in IBD Analyzed

The study suggests endoscopic remission also be a criterion in anti-TNF discontinuation
The study suggests endoscopic remission also be a criterion in anti-TNF discontinuation

About one-third of patients with inflammatory bowel disease in remission, relapsed 1 year after discontinuing anti-TNF treatment, a meta-analysis published in the American Journal of Gastroenterology has shown. 

A team of researchers conducted a meta-analysis to assess the risk of relapse after discontinuation of anti-tumor necrosis factor (anti-TNF) treatment in patients with Crohn's disease (CD) and ulcerative colitis (UC), to identify risk factors for relapse, and to assess the response to retreatment with the same anti-TNF treatments.

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The researchers included studies evaluating relapse after anti-TNF discontinuation in patients with CD or UC in remission with anti-TNFs; they calculated frequency of relapse after discontinuation of anti-TNFs. A total of 27 studies—21 on infliximab and 6 on infliximab/adalimumab—were included for analysis.

The data revealed a 44% overall risk of relapse after discontinuing anti-TNF therapy for CD (95% CI: 36–51) and 38% for UC (95% CI: 23–52%). In CD, the rate of relapse was 38% at 6 months after discontinuation, 40% at 12 months, and 49% at >25 months. In UC, relapse was seen in 28% of patients after 12 months.

Moreover, the rate of relapse 12 months after discontinuing was 42% when clinical remission was the only criteria for discontinuing anti-TNF therapy in CD; this rate dropped to 26% when endoscopic remission was also a required criterion. Eighty percent of the cases went in remission again when retreated with the same anti-TNF treatment. Overall, study authors concluded that patient response was favorable when retreated with the same anti-TNF drug.

For more information visit nature.com.

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