scholarly journals Editorial: risk of loss of response to anti‐TNFα agents in patients with inflammatory bowel disease—the longer the less?

2021 ◽  
Vol 55 (2) ◽  
pp. 244-245
Author(s):  
Idan Goren ◽  
Henit Yanai
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Loss Of Response ◽  
Inflammatory Bowel

scholarly journals P605 Eight-year efficacy and safety of azathioprine treatment in the maintenance of steroid-free remission in inflammatory bowel disease patients

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S505-S505
Author(s):  
C Cassieri ◽  
R Pica ◽  
E V Avallone ◽  
G Brandimarte ◽  
M Zippi ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Side Effects ◽  
Bowel Disease ◽  
Efficacy And Safety ◽  
Loss Of Response ◽  
Steroid Dependent ◽  
Azathioprine Treatment ◽  
Inflammatory Bowel ◽  
Maintenance Of Remission

Abstract Background Azathioprine (AZA) and thiopurine are widely used for induction and maintenance of remission in steroid-dependent patients with inflammatory bowel disease (IBD). The aim of this study has been to investigate its efficacy and safety in maintaining steroid-free remission in steroid-dependent IBD patients eight years after the institution of treatment. Methods Data from consecutive IBD outpatients referred in our Institution, between 1985–2017, were reviewed and all patients treated with AZA were included in this retrospective study. AZA was administered at the recommended dose of 2–2.5 mg/kg. Results Out of 2992 consecutive IBD outpatients visited in the index period, AZA was prescribed to 446 patients, 245 (54.9%) were affected by Crohn’s disease (CD) and 201 (45.1%) by ulcerative colitis (UC). One hundred and ninety-six patients with a follow-up < 96 months were excluded from the study. Two hundred and fifty patients were evaluated, 140 (56%) with CD and 110 (44%) with UC. One hundred and thirty-eight (55.2%) were male and 112 (44.8%) female (average age of 35.48 ± 14.26 SD years, range 14–74 years). Eight year after the institution of treatment, 123 (49.2%) patients still were in steroid-free remission (82 CD vs. 41 UC, 58.6% and 37.3%, respectively, p = 0.0009), 71 (28.4%) had a relapse requiring retreatment with steroids (29 CD vs. 42 UC, 20.7% and 38.2%, respectively, p = 0.0030), 56 (22.4%) discontinued the treatment due to side effects (29 CD vs. 27 UC, 20.7% and 24.5%, respectively). The loss of response from first to eighth year of follow-up was low, about 21%. Conclusion Eight years after the onset of treatment about 50% of patients did not require further steroid courses. After the first-year loss of response was low in seven subsequent years. In the present series, the maintenance of steroid-free remission was significantly higher in CD than in UC patients. The occurrence of side effects leading to the withdrawal of AZA treatment has been low.

scholarly journals Effectiveness and Safety of the Sequential Use of a Second and Third Anti-TNF Agent in Patients With Inflammatory Bowel Disease: Results From the Eneida Registry

2019 ◽  
Author(s):  
María José Casanova ◽  
María Chaparro ◽  
Miguel Mínguez ◽  
Elena Ricart ◽  
Carlos Taxonera ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Combination Therapy ◽  
Adverse Events ◽  
Bowel Disease ◽  
Tumor Necrosis ◽  
Significant Proportion ◽  
Short Term ◽  
Loss Of Response ◽  
Inflammatory Bowel ◽  
Necrosis Factor

Abstract Background The effectiveness of the switch to another anti–tumor necrosis factor (anti-TNF) agent is not known. The aim of this study was to analyze the effectiveness and safety of treatment with a second and third anti-TNF drug after intolerance to or failure of a previous anti-TNF agent in inflammatory bowel disease (IBD) patients. Methods We included patients diagnosed with IBD from the ENEIDA registry who received another anti-TNF after intolerance to or failure of a prior anti-TNF agent. Results A total of 1122 patients were included. In the short term, remission was achieved in 55% of the patients with the second anti-TNF. The incidence of loss of response was 19% per patient-year with the second anti-TNF. Combination therapy (hazard ratio [HR], 2.4; 95% confidence interval [CI], 1.8–3; P < 0.0001) and ulcerative colitis vs Crohn’s disease (HR, 1.6; 95% CI, 1.1–2.1; P = 0.005) were associated with a higher probability of loss of response. Fifteen percent of the patients had adverse events, and 10% had to discontinue the second anti-TNF. Of the 71 patients who received a third anti-TNF, 55% achieved remission. The incidence of loss of response was 22% per patient-year with a third anti-TNF. Adverse events occurred in 7 patients (11%), but only 1 stopped the drug. Conclusions Approximately half of the patients who received a second anti-TNF achieved remission; nevertheless, a significant proportion of them subsequently lost response. Combination therapy and type of IBD were associated with loss of response. Remission was achieved in almost 50% of patients who received a third anti-TNF; nevertheless, a significant proportion of them subsequently lost response.

scholarly journals P635 Carriage of the HLA-DQA1*05 allele is associated with a high risk of loss of response to infliximab in patients with inflammatory bowel disease

2019 ◽  
Vol 13 (Supplement_1) ◽  
pp. S435-S436
Author(s):  
J Guardiola ◽  
L Rodriguez Alonso ◽  
E Santacana ◽  
A Padró ◽  
K Serra ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
High Risk ◽  
Bowel Disease ◽  
Loss Of Response ◽  
Inflammatory Bowel ◽  
Hla Dqa1

Sa1746 VEDOLIZUMAB DOSE ESCALATION IN PATIENTS WITH INFLAMMATORY BOWEL DISEASE EXPERIENCING LOSS OF RESPONSE: A SYSTEMATIC REVIEW AND META-ANALYSIS OF REAL-WORLD EVIDENCE

2020 ◽  
Vol 158 (6) ◽  
pp. S-406-S-407
Author(s):  
Della Varghese ◽  
Dipen Patel ◽  
Stephan Martin ◽  
Michelle Luo ◽  
Lyann Ursos ◽  
...  
Keyword(s):  
Systematic Review ◽  
Inflammatory Bowel Disease ◽  
Dose Escalation ◽  
Real World ◽  
Bowel Disease ◽  
Meta Analysis ◽  
Loss Of Response ◽  
Real World Evidence ◽  
Inflammatory Bowel

Sa1942 Infliximab Trough Level Measured During Treatment Induction May Be Predictive of the Loss of Response to Infliximab During Treatment Maintenance in Inflammatory Bowel Disease Patients: A Longitudinal Observational Retrospective Study

2016 ◽  
Vol 150 (4) ◽  
pp. S411
Author(s):  
Claire Liefferinckx ◽  
Charlotte Minsart ◽  
Anneline Cremer ◽  
Jean-François Toubeau ◽  
Leila Amininejad ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Retrospective Study ◽  
Bowel Disease ◽  
Trough Level ◽  
Loss Of Response ◽  
Inflammatory Bowel
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