Outcomes 7 Years After Infliximab Withdrawal ...
Type de document :
Article dans une revue scientifique
PMID :
URL permanente :
Titre :
Outcomes 7 Years After Infliximab Withdrawal for Patients With Crohn''s Disease in Sustained Remission
Auteur(s) :
Reenaers, Catherine [Auteur]
Mary, Jean-Yves [Auteur]
Université Paris Diderot - Paris 7 [UPD7]
Nachury, Maria [Auteur]
Lille Inflammation Research International Center - U 995 [LIRIC]
Bouhnik, Yoram [Auteur]
Université Paris Diderot - Paris 7 [UPD7]
Laharie, David [Auteur]
Université de Bordeaux [UB]
Allez, Matthieu [Auteur]
Université Paris Diderot - Paris 7 [UPD7]
Fumery, Mathurin [Auteur]
Lille Inflammation Research International Center - U 995 [LIRIC]
Amiot, Aurelien [Auteur]
Université Paris-Est Créteil Val-de-Marne - Paris 12 [UPEC UP12]
Savoye, Guillaume [Auteur]
Université de Rouen Normandie [UNIROUEN]
Altwegg, Romain [Auteur]
De Vos, Martine [Auteur]
Malamut, Georgia [Auteur]
Université Paris Descartes - Paris 5 [UPD5]
Bourreille, Arnaud [Auteur]
Flourie, Bernard [Auteur]
Marteau, Philippe [Auteur]
Université Paris Diderot - Paris 7 [UPD7]
Vuitton, Lucine [Auteur]
Coffin, Benoit [Auteur]
Université Paris Diderot - Paris 7 [UPD7]
Viennot, Stephanie [Auteur]
Lambert, Jerome [Auteur]
Université Paris Diderot - Paris 7 [UPD7]
Colombel, Jean-Frederic [Auteur]
Louis, Edouard [Auteur]
Mary, Jean-Yves [Auteur]
Université Paris Diderot - Paris 7 [UPD7]
Nachury, Maria [Auteur]
Lille Inflammation Research International Center - U 995 [LIRIC]
Bouhnik, Yoram [Auteur]
Université Paris Diderot - Paris 7 [UPD7]
Laharie, David [Auteur]
Université de Bordeaux [UB]
Allez, Matthieu [Auteur]
Université Paris Diderot - Paris 7 [UPD7]
Fumery, Mathurin [Auteur]
Lille Inflammation Research International Center - U 995 [LIRIC]
Amiot, Aurelien [Auteur]
Université Paris-Est Créteil Val-de-Marne - Paris 12 [UPEC UP12]
Savoye, Guillaume [Auteur]
Université de Rouen Normandie [UNIROUEN]
Altwegg, Romain [Auteur]
De Vos, Martine [Auteur]
Malamut, Georgia [Auteur]
Université Paris Descartes - Paris 5 [UPD5]
Bourreille, Arnaud [Auteur]
Flourie, Bernard [Auteur]
Marteau, Philippe [Auteur]
Université Paris Diderot - Paris 7 [UPD7]
Vuitton, Lucine [Auteur]
Coffin, Benoit [Auteur]
Université Paris Diderot - Paris 7 [UPD7]
Viennot, Stephanie [Auteur]
Lambert, Jerome [Auteur]
Université Paris Diderot - Paris 7 [UPD7]
Colombel, Jean-Frederic [Auteur]
Louis, Edouard [Auteur]
Titre de la revue :
Clinical Gastroenterology and Hepatology
Nom court de la revue :
Clin. Gastroenterol. Hepatol.
Numéro :
16
Pagination :
234-243.e2
Date de publication :
2018-02
ISSN :
1542-3565
Mot(s)-clé(s) :
Success
GETAID
IFX
Anti-TNF
GETAID
IFX
Anti-TNF
Discipline(s) HAL :
Sciences du Vivant [q-bio]
Résumé en anglais : [en]
Background & Aims: Little is known about long-term outcomes of patients with Crohn’s disease (CD) after infliximab withdrawal. We aimed to describe the long-term outcomes of patients with CD in clinical remission after ...
Lire la suite >Background & Aims: Little is known about long-term outcomes of patients with Crohn’s disease (CD) after infliximab withdrawal. We aimed to describe the long-term outcomes of patients with CD in clinical remission after infliximab treatment was withdrawn. Methods: We performed a retrospective analysis of data from the 115 patients included in the infliximab discontinuation in patients with CD in stable remission on combined therapy with antimetabolites (STORI) study, performed at 20 centers in France and Belgium from March 2006 through December 2009. The STORI cohort was a prospective analysis of risk and factors associated with relapse following withdrawal of maintenance therapy with infliximab, maintained on antimetabolites, while in clinical remission. We collected data from the end of the study until the last available follow-up examination on patient surgeries, new complex perianal lesions (indicating major complications), and need for and outcomes of restarting therapy with infliximab or another biologic agent. The de-escalation strategy was considered to have failed when a major complication or infliximab restart failure occurred. Results: Of the 115 patients initially included, data from 102 patients (from 19 of the 20 study centers) were included in the final analysis. The median follow-up time was 7 years. Twenty-one percent of the patients did not restart treatment with infliximab or another biologic agent and did not have a major complication 7 years after infliximab withdrawal (95% CI, 13.1–30.3). Among patients who restarted infliximab, treatment failed for 30.1% 6 years after restarting (95% CI, 18.5–42.5). Overall, at 7 years after stopping infliximab therapy, major complications occurred in 18.5% of patients (95% CI, 10.2–26.8) whereas 70.2% of patients had no failure of the de-escalation strategy (95% CI, 60.2–80.1). Factors independently associated with major complications were upper-gastrointestinal location of disease, white blood cell count ≥ 5.0 × 109/L, and hemoglobin level ≤12.5 g/dL at the time of infliximab withdrawal. Patients with at least 2 of these factors had a more than 40% risk of major complication in the 7 years following infliximab withdrawal. Conclusions: In a long-term follow-up of the STORI cohort (7 years) one fifth of the patients did not restart infliximab or another biologic agent and did not develop major complications. Seventy percent of patients had no failure of the de-escalation strategy (no major complication and no failure of infliximab restart).Lire moins >
Lire la suite >Background & Aims: Little is known about long-term outcomes of patients with Crohn’s disease (CD) after infliximab withdrawal. We aimed to describe the long-term outcomes of patients with CD in clinical remission after infliximab treatment was withdrawn. Methods: We performed a retrospective analysis of data from the 115 patients included in the infliximab discontinuation in patients with CD in stable remission on combined therapy with antimetabolites (STORI) study, performed at 20 centers in France and Belgium from March 2006 through December 2009. The STORI cohort was a prospective analysis of risk and factors associated with relapse following withdrawal of maintenance therapy with infliximab, maintained on antimetabolites, while in clinical remission. We collected data from the end of the study until the last available follow-up examination on patient surgeries, new complex perianal lesions (indicating major complications), and need for and outcomes of restarting therapy with infliximab or another biologic agent. The de-escalation strategy was considered to have failed when a major complication or infliximab restart failure occurred. Results: Of the 115 patients initially included, data from 102 patients (from 19 of the 20 study centers) were included in the final analysis. The median follow-up time was 7 years. Twenty-one percent of the patients did not restart treatment with infliximab or another biologic agent and did not have a major complication 7 years after infliximab withdrawal (95% CI, 13.1–30.3). Among patients who restarted infliximab, treatment failed for 30.1% 6 years after restarting (95% CI, 18.5–42.5). Overall, at 7 years after stopping infliximab therapy, major complications occurred in 18.5% of patients (95% CI, 10.2–26.8) whereas 70.2% of patients had no failure of the de-escalation strategy (95% CI, 60.2–80.1). Factors independently associated with major complications were upper-gastrointestinal location of disease, white blood cell count ≥ 5.0 × 109/L, and hemoglobin level ≤12.5 g/dL at the time of infliximab withdrawal. Patients with at least 2 of these factors had a more than 40% risk of major complication in the 7 years following infliximab withdrawal. Conclusions: In a long-term follow-up of the STORI cohort (7 years) one fifth of the patients did not restart infliximab or another biologic agent and did not develop major complications. Seventy percent of patients had no failure of the de-escalation strategy (no major complication and no failure of infliximab restart).Lire moins >
Langue :
Anglais
Audience :
Internationale
Vulgarisation :
Non
Établissement(s) :
Inserm
Université de Lille
CHU Lille
Université de Lille
CHU Lille
Équipe(s) de recherche :
Inflammatory digestive disease : pathophysiology and therapeutic targets developement
Date de dépôt :
2019-03-01T14:35:17Z
2024-02-01T13:54:49Z
2024-02-01T13:54:49Z