Titre :

Effectiveness and safety of anti-TNF therapy for inflammatory bowel disease in liver transplant recipients for primary sclerosing cholangitis: A nationwide case series.

Auteur(s) :

Altwegg, Romain [Auteur]
Combes, Roman [Auteur]
Laharie, David [Auteur]
De Ledinghen, Victor [Auteur]
Radenne, Sylvie [Auteur]
Conti, Filomena [Auteur]
Chazouilleres, Olivier [Auteur]
Duvoux, Christophe [Auteur]
Dumortier, Jerome [Auteur]
Leroy, Vincent [Auteur]
Treton, Xavier [Auteur]
Durand, Francois [Auteur]
Dharancy, Sebastien [Auteur]
Lille Inflammation Research International Center - U 995 [LIRIC]
Nachury, Maria [Auteur]
Lille Inflammation Research International Center - U 995 [LIRIC]
Goutorbe, Felix [Auteur]
Lamblin, Geraldine [Auteur]
Boivineau, Lucile [Auteur]
Peyrin-Biroulet, Laurent [Auteur]
Pageaux, Georges-Philippe [Auteur]

Titre de la revue :

Digestive and Liver Disease

Nom court de la revue :

Dig. Liver Dis.

Numéro :

50

Pagination :

668-674

Date de publication :

2018-07

Mot(s)-clé(s) :

Inflammatory bowel disease
Anti-TNF alpha
Liver transplantation

Discipline(s) HAL :

Sciences du Vivant [q-bio]

Résumé en anglais : [en]

Background: There is a lack of consensus regarding the treatment of inflammatory bowel disease (IBD) after liver transplantation (LT) forprimary sclerosing cholangitis (PSC). Aim: To investigate the safety and effectiveness ...
Lire la suite >Background: There is a lack of consensus regarding the treatment of inflammatory bowel disease (IBD) after liver transplantation (LT) forprimary sclerosing cholangitis (PSC). Aim: To investigate the safety and effectiveness of anti-TNF therapy in patients with IBD after a LT for PSC. Methods: We reviewed the medical files of all of the IBD patients who underwent a LT for PSC and who were treated with anti-TNF therapy at 23 French liver transplantation centers between 1989 and 2012. Results: Eighteen patients (12 with ulcerative colitis and 6 who had Crohn’s disease) were recruited at 9 LT centers. All of these patients received infliximab or adalimumab following their LT, and the median duration of their anti-TNF treatment was 10.4 months. The most frequent concomitant immunosuppressive treatment comprised a combination of tacrolimus and corticosteroids. Following anti-TNF therapy induction, a clinical response was seen in 16/18 patients (89%) and clinical remission in 10 (56%). At the end of the anti-TNF treatment or at the last follow-up examination (the median follow-up was 20.9 months), a clinical response was achieved in 12 patients (67%) and clinical remission in 7 (39%). A significant endoscopic improvement was observed in 9 out of 14 patients and a complete mucosal healing in 3 out of 14 patients (21%). Six patients experienced a severe infection. These were due to cholangitis, cytomegalovirus (CMV) infection, Clostridium difficile, cryptosporidiosis, or Enterococcus faecalis. Three patients developed colorectal cancer after LT, and two patients died during the follow-up period. Conclusions: Anti-TNF therapy proved to be effective for treating IBD after LT for PSC. However, as 17% of the patients developed colorectal cancer during the follow-up, colonoscopic annual surveillance is recommended after LT, as specified in the current guidelines.Lire moins >

Langue :

Anglais

Audience :

Internationale

Vulgarisation :

Non

Établissement(s) :

Inserm
Université de Lille
CHU Lille

Collections :

• Institut de Recherche Translationnelle sur l'Inflammation (INFINITE) - U1286

Équipe(s) de recherche :

Inflammatory digestive disease : pathophysiology and therapeutic targets developement

Date de dépôt :

2019-03-01T14:34:45Z
2023-12-06T10:39:08Z