Efficacy and safety of tumor necrosis ...
Document type :
Article dans une revue scientifique: Article original
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Title :
Efficacy and safety of tumor necrosis factor antagonists in treatment of internal fistulizing crohn''s disease
Author(s) :
Bouguen, Guillaume [Auteur]
Centre d'Investigation Clinique [Rennes] [CIC]
Huguet, Audrey [Auteur]
Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Pontchaillou]
Amiot, Aurelien [Auteur]
Université Paris-Est Créteil Val-de-Marne - Paris 12 [UPEC UP12]
Viennot, Stephanie [Auteur]
CHU Caen
Cholet, Franck [Auteur]
Centre Hospitalier Régional Universitaire de Brest [CHRU Brest]
Nachury, Maria [Auteur]
Lille Inflammation Research International Center - U 995 [LIRIC]
Flamant, Mathurin [Auteur]
Institut des Maladies de l'Appareil Digestif
Reimund, Jean-Marie [Auteur]
Interface de Recherche Fondamentale et Appliquée en Cancérologie [IRFAC - Inserm U1113]
Desfourneaux, Veronique [Auteur]
Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Pontchaillou]
Bourreille, Arnaud [Auteur]
The Enteric Nervous System in gut and brain disorders [U1235] [TENS]
Siproudhis, Laurent [Auteur]
Centre d'Investigation Clinique [Rennes] [CIC]
Centre d'Investigation Clinique [Rennes] [CIC]
Huguet, Audrey [Auteur]
Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Pontchaillou]
Amiot, Aurelien [Auteur]
Université Paris-Est Créteil Val-de-Marne - Paris 12 [UPEC UP12]
Viennot, Stephanie [Auteur]
CHU Caen
Cholet, Franck [Auteur]
Centre Hospitalier Régional Universitaire de Brest [CHRU Brest]
Nachury, Maria [Auteur]

Lille Inflammation Research International Center - U 995 [LIRIC]
Flamant, Mathurin [Auteur]
Institut des Maladies de l'Appareil Digestif
Reimund, Jean-Marie [Auteur]
Interface de Recherche Fondamentale et Appliquée en Cancérologie [IRFAC - Inserm U1113]
Desfourneaux, Veronique [Auteur]
Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Pontchaillou]
Bourreille, Arnaud [Auteur]
The Enteric Nervous System in gut and brain disorders [U1235] [TENS]
Siproudhis, Laurent [Auteur]
Centre d'Investigation Clinique [Rennes] [CIC]
Journal title :
Clinical Gastroenterology and Hepatology
Abbreviated title :
Clin. Gastroenterol. Hepatol.
Volume number :
18
Pages :
628-636
Publication date :
2020-03
ISSN :
1542-7714
English keyword(s) :
Inflammatory Bowel Disease
Prognostic Factor
GETAID
Infliximab
Prognostic Factor
GETAID
Infliximab
HAL domain(s) :
Sciences du Vivant [q-bio]
English abstract : [en]
Few data are available on the effects of tumor necrosis factor (TNF) antagonist therapy for patients with internal fistulizing Crohn's disease (CD) and there is debate regarding the risk of abscess. We aimed to assess the ...
Show more >Few data are available on the effects of tumor necrosis factor (TNF) antagonist therapy for patients with internal fistulizing Crohn's disease (CD) and there is debate regarding the risk of abscess. We aimed to assess the long-term efficacy and safety of anti-TNF therapy for patients with internal fistulas. We performed a retrospective study of data collected from the Groupe d'Etude Thérapeutique des Affections Inflammatoires Digestives trial, from January 1, 2000, through December 31, 2017. Our final analysis included 156 patients who began treatment with an anti-TNF agent for CD with internal fistula (83 men; median disease duration, 4.9 y). The primary end point was the onset of a major abdominal surgery. Secondary analysis included disappearance of the fistula tract during follow-up evaluation and safety. The Kaplan-Meier method was used for statistical analysis. After a median follow-up period of 3.5 years, 68 patients (43.6%) underwent a major abdominal surgery. The cumulative probabilities for being surgery-free were 83%, 64%, and 51% at 1, 3, and 5 years, respectively. A concentration of C-reactive protein >18 mg/L, an albumin concentration <36 g/L, the presence of an abscess at the fistula diagnosis, and the presence of a stricture were associated independently with the need for surgery. The cumulative probabilities of fistula healing, based on imaging analyses, were 15.4%, 32.3%, and 43.9% at 1, 3, and 5 years, respectively. Thirty-two patients (20.5%) developed an intestinal abscess and 4 patients died from malignancies (3 intestinal adenocarcinomas). One patient died from septic shock 3 months after initiation of anti-TNF therapy. In a retrospective analysis of data from a large clinical trial, we found that anti-TNF therapy delays or prevents surgery for almost half of patients with CD and luminal fistulas. However, anti-TNF therapy might increase the risk for sepsis-related death or gastrointestinal malignancies.Show less >
Show more >Few data are available on the effects of tumor necrosis factor (TNF) antagonist therapy for patients with internal fistulizing Crohn's disease (CD) and there is debate regarding the risk of abscess. We aimed to assess the long-term efficacy and safety of anti-TNF therapy for patients with internal fistulas. We performed a retrospective study of data collected from the Groupe d'Etude Thérapeutique des Affections Inflammatoires Digestives trial, from January 1, 2000, through December 31, 2017. Our final analysis included 156 patients who began treatment with an anti-TNF agent for CD with internal fistula (83 men; median disease duration, 4.9 y). The primary end point was the onset of a major abdominal surgery. Secondary analysis included disappearance of the fistula tract during follow-up evaluation and safety. The Kaplan-Meier method was used for statistical analysis. After a median follow-up period of 3.5 years, 68 patients (43.6%) underwent a major abdominal surgery. The cumulative probabilities for being surgery-free were 83%, 64%, and 51% at 1, 3, and 5 years, respectively. A concentration of C-reactive protein >18 mg/L, an albumin concentration <36 g/L, the presence of an abscess at the fistula diagnosis, and the presence of a stricture were associated independently with the need for surgery. The cumulative probabilities of fistula healing, based on imaging analyses, were 15.4%, 32.3%, and 43.9% at 1, 3, and 5 years, respectively. Thirty-two patients (20.5%) developed an intestinal abscess and 4 patients died from malignancies (3 intestinal adenocarcinomas). One patient died from septic shock 3 months after initiation of anti-TNF therapy. In a retrospective analysis of data from a large clinical trial, we found that anti-TNF therapy delays or prevents surgery for almost half of patients with CD and luminal fistulas. However, anti-TNF therapy might increase the risk for sepsis-related death or gastrointestinal malignancies.Show less >
Language :
Anglais
Audience :
Internationale
Popular science :
Non
Administrative institution(s) :
CHU Lille
Inserm
Université de Lille
Inserm
Université de Lille
Submission date :
2024-01-30T10:28:22Z
2024-05-07T11:16:23Z
2024-05-07T11:16:23Z
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