Relapse rates of inflammatory bowel disease patients in deep and clinical remission after discontinuing anti-tumor necrosis factor alpha therapy
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. All IBD pa...
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| Veröffentlicht in: | Bratislava Medical Journal 2016, Vol.117 (4), p.205-211 |
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| container_title | Bratislava Medical Journal |
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| creator | Hlavaty, T Krajcovicova, A Letkovsky, J Sturdik, I Koller, T Toth, J Huorka, M |
| description | 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.
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 ( |
| doi_str_mv | 10.4149/BLL_2016_039 |
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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.
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).
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).</description><identifier>ISSN: 0006-9248</identifier><identifier>ISSN: 1336-0345</identifier><identifier>EISSN: 1336-0345</identifier><identifier>DOI: 10.4149/BLL_2016_039</identifier><identifier>PMID: 27075383</identifier><language>eng</language><publisher>Slovakia</publisher><subject>Adult ; Aged ; Colitis, Ulcerative - blood ; Colitis, Ulcerative - drug therapy ; Colitis, Ulcerative - pathology ; Colitis, Ulcerative - physiopathology ; Crohn Disease - blood ; Crohn Disease - drug therapy ; Crohn Disease - pathology ; Crohn Disease - physiopathology ; Female ; Follow-Up Studies ; Gastrointestinal Agents - administration & dosage ; Gastrointestinal Agents - adverse effects ; Humans ; Infliximab - administration & dosage ; Infliximab - adverse effects ; Leukocyte L1 Antigen Complex - blood ; Male ; Middle Aged ; Prospective Studies ; Recurrence ; Risk Assessment ; Risk Factors ; Time Factors ; Tumor Necrosis Factor-alpha - antagonists & inhibitors ; Withholding Treatment - statistics & numerical data</subject><ispartof>Bratislava Medical Journal, 2016, Vol.117 (4), p.205-211</ispartof><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,4024,27923,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27075383$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hlavaty, T</creatorcontrib><creatorcontrib>Krajcovicova, A</creatorcontrib><creatorcontrib>Letkovsky, J</creatorcontrib><creatorcontrib>Sturdik, I</creatorcontrib><creatorcontrib>Koller, T</creatorcontrib><creatorcontrib>Toth, J</creatorcontrib><creatorcontrib>Huorka, M</creatorcontrib><title>Relapse rates of inflammatory bowel disease patients in deep and clinical remission after discontinuing anti-tumor necrosis factor alpha therapy</title><title>Bratislava Medical Journal</title><addtitle>Bratisl Lek Listy</addtitle><description>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.
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.
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).
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).</description><subject>Adult</subject><subject>Aged</subject><subject>Colitis, Ulcerative - blood</subject><subject>Colitis, Ulcerative - drug therapy</subject><subject>Colitis, Ulcerative - pathology</subject><subject>Colitis, Ulcerative - physiopathology</subject><subject>Crohn Disease - blood</subject><subject>Crohn Disease - drug therapy</subject><subject>Crohn Disease - pathology</subject><subject>Crohn Disease - physiopathology</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Gastrointestinal Agents - administration & dosage</subject><subject>Gastrointestinal Agents - adverse effects</subject><subject>Humans</subject><subject>Infliximab - administration & dosage</subject><subject>Infliximab - adverse effects</subject><subject>Leukocyte L1 Antigen Complex - blood</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Prospective Studies</subject><subject>Recurrence</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>Time Factors</subject><subject>Tumor Necrosis Factor-alpha - antagonists & inhibitors</subject><subject>Withholding Treatment - statistics & numerical data</subject><issn>0006-9248</issn><issn>1336-0345</issn><issn>1336-0345</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpN0U1P3DAQBmCralUW6I0z8rEHUvyd5EgRLZVWQqraczTrjMHIsYPtCO2_4Cc3K2jV01yeeWc0Q8gZZ18UV_3l1-12EIybgcn-HdlwKU3DpNLvyYYxZppeqO6IHJfyyJiSmpuP5Ei0rNWykxvy8hMDzAVphoqFJkd9dAGmCWrKe7pLzxjo6AvCamaoHmMtq6Ej4kwhjtQGH72FQDNOvhSfIgVXMR-6bIrVx8XH-5VW39RlSplGtDkVX6gDu06hEOYHoPUBM8z7U_LBQSj46a2ekN_fbn5d3zbbu-8_rq-2jVXC1EZzJ92OgRk7MNZpg6CFaHlrLO_cTvXtKJVA1zNpuOsYttqajmPPRmG1aOUJ-fyaO-f0tGCpw7q9xRAgYlrKwNuOa8WF6FZ68UoPa5eMbpiznyDvB86Gww-G_3-w8vO35GU34fgP_z26_AND7oUX</recordid><startdate>2016</startdate><enddate>2016</enddate><creator>Hlavaty, T</creator><creator>Krajcovicova, A</creator><creator>Letkovsky, J</creator><creator>Sturdik, I</creator><creator>Koller, T</creator><creator>Toth, J</creator><creator>Huorka, M</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>2016</creationdate><title>Relapse rates of inflammatory bowel disease patients in deep and clinical remission after discontinuing anti-tumor necrosis factor alpha therapy</title><author>Hlavaty, T ; Krajcovicova, A ; Letkovsky, J ; Sturdik, I ; Koller, T ; Toth, J ; Huorka, M</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c426t-51f3fb0a6d8a6cf56ea5227176c18fb497d342ef90361f80e75c681e90d2c5273</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Colitis, Ulcerative - blood</topic><topic>Colitis, Ulcerative - drug therapy</topic><topic>Colitis, Ulcerative - pathology</topic><topic>Colitis, Ulcerative - physiopathology</topic><topic>Crohn Disease - blood</topic><topic>Crohn Disease - drug therapy</topic><topic>Crohn Disease - pathology</topic><topic>Crohn Disease - physiopathology</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Gastrointestinal Agents - administration & dosage</topic><topic>Gastrointestinal Agents - adverse effects</topic><topic>Humans</topic><topic>Infliximab - administration & dosage</topic><topic>Infliximab - adverse effects</topic><topic>Leukocyte L1 Antigen Complex - blood</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Prospective Studies</topic><topic>Recurrence</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>Time Factors</topic><topic>Tumor Necrosis Factor-alpha - antagonists & inhibitors</topic><topic>Withholding Treatment - statistics & numerical data</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hlavaty, T</creatorcontrib><creatorcontrib>Krajcovicova, A</creatorcontrib><creatorcontrib>Letkovsky, J</creatorcontrib><creatorcontrib>Sturdik, I</creatorcontrib><creatorcontrib>Koller, T</creatorcontrib><creatorcontrib>Toth, J</creatorcontrib><creatorcontrib>Huorka, M</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Bratislava Medical Journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hlavaty, T</au><au>Krajcovicova, A</au><au>Letkovsky, J</au><au>Sturdik, I</au><au>Koller, T</au><au>Toth, J</au><au>Huorka, M</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Relapse rates of inflammatory bowel disease patients in deep and clinical remission after discontinuing anti-tumor necrosis factor alpha therapy</atitle><jtitle>Bratislava Medical Journal</jtitle><addtitle>Bratisl Lek Listy</addtitle><date>2016</date><risdate>2016</risdate><volume>117</volume><issue>4</issue><spage>205</spage><epage>211</epage><pages>205-211</pages><issn>0006-9248</issn><issn>1336-0345</issn><eissn>1336-0345</eissn><abstract>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.
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.
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).
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).</abstract><cop>Slovakia</cop><pmid>27075383</pmid><doi>10.4149/BLL_2016_039</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Aged Colitis, Ulcerative - blood Colitis, Ulcerative - drug therapy Colitis, Ulcerative - pathology Colitis, Ulcerative - physiopathology Crohn Disease - blood Crohn Disease - drug therapy Crohn Disease - pathology Crohn Disease - physiopathology Female Follow-Up Studies Gastrointestinal Agents - administration & dosage Gastrointestinal Agents - adverse effects Humans Infliximab - administration & dosage Infliximab - adverse effects Leukocyte L1 Antigen Complex - blood Male Middle Aged Prospective Studies Recurrence Risk Assessment Risk Factors Time Factors Tumor Necrosis Factor-alpha - antagonists & inhibitors Withholding Treatment - statistics & numerical data |
| title | Relapse rates of inflammatory bowel disease patients in deep and clinical remission after discontinuing anti-tumor necrosis factor alpha therapy |
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