Home Bratislava Medical Journal 2016 Bratislava Medical Journal Vol.116, No.4, p.205-211, 2016

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Published Monthly, in English
Founded: 1919
ISSN 0006-9248
(E)ISSN 1336-0345

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Bratislava Medical Journal Vol.116, No.4, p.205-211, 2016

Title: Relapse rates of inflammatory bowel disease patients in deep and clinical remission after discontinuing anti-tumor necrosis factor alpha therapy
Author: T. Hlavaty, A. Krajcovicova, J. Letkovsky, I. Sturdik, T. Koller, J. Toth, M. Huorka

Abstract:

BACKGROUND AND AIMS: Relapse rates after discontinuing anti-tumor necrosis factor-α (TNFα) therapy of inflammatory bowel disease (IBD) patients in deep remission are poorly understood. This prospective single-center open-label study evaluated the relapse rates of IBD patients after stopping anti-TNFα therapy.
METHODS: All IBD patients who were in clinical remission and stopped anti-TNFα therapy in 2011–2013 and were followed up for at least 12 months were enrolled. The “Ultradeep” patients were in calprotectin-negative (<50 ng/g) deep remission for at least six months and ceased anti-TNFα therapy on physician recommendations. The “clinical” patients were in clinical but not deep remission and ceased anti-TNFα therapy for other reasons. Relapse rates were assessed and relapse risk factors identified.


RESULTS: One year after stopping, 27 % and 27 % of the Ultradeep (n = 11) and Clinical (n = 11) patients relapsed, respectively. Two years after stopping, 57 % and 62 % relapsed, respectively (p = 0.89). All relapsed patients who underwent retreatment with anti-TNFα therapy re-entered remission. Male sex was a significant risk factor for relapse (p = 0.03).
CONCLUSION: Our study showed that even highly selected IBD patients who lack clinical, endoscopic or laboratory signs of disease activity have a relatively high relapse rate in the follow-up period after ceasing anti-TNFα therapy (Tab. 2, Fig. 3, Ref. 24).



Keywords: Crohn’s disease, ulcerative colitis, infliximab, adalimumab, treatment discontinuation, relapse rate
Published online: 04-Apr-2016
Year: 2016, Volume: 116, Issue: 4 Page From: 205, Page To: 211
doi:10.4149/BLL_2016_039


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