Article (Scientific journals)
Anti-TNF Monotherapy for Crohn's Disease: a 13-year Multicentre Experience.
Peyrin-Biroulet, Laurent; Salleron, Julia; Filippi, Jerome et al.
2016In Journal of Crohn's and Colitis, 10 (5), p. 516-24
Peer Reviewed verified by ORBi
 

Files


Full Text
Anti-TNF Monotherapy for Crohn's disease a 13-year multicentre experience-JCC-PostPE.pdf
Publisher postprint (860.08 kB)
Download

Copyright © 2016 European Crohn’s and Colitis Organisation (ECCO). Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com


All documents in ORBi are protected by a user license.

Send to



Details



Keywords :
Crohn's disease; Infliximab; adalimumab; anti-TNF monotherapy
Abstract :
[en] BACKGROUND: Anti-tumour necrosis factor [TNF] therapy in combination with thiopurine is the most effective strategy for Crohn's disease, but raises safety concerns. METHODS: In a retrospective multicentre study, we investigated long-term outcome of patients starting anti-TNF monotherapy for Crohn's disease and investigated whether introducing an immunomodulator in patients losing response to anti-TNF monotherapy is effective for resetting immunogenicity. RESULTS: A total of 350 adult patients with Crohn's disease received either infliximab [n = 178, 51%] or adalimumab [n = 172, 49%] monotherapy. Mean duration of follow-up was 42 months. An immunomodulator was initiated in 53 patients [15%]. At last follow-up, 73.1% [n = 38] were in clinical remission [one patient with missing data]. Multivariate analysis identified anti-TNF type [higher need for starting immunomodulator for infliximab than for adalimumab; p = 0.0058] and first- vs second-/third-/fourth-line anti-TNF therapy [p = 0.014] as predictors of immunomodulator initiation. Among the 18 patients with available data, introduction of an immunomodulator was able to restore infliximab trough level within the therapeutic range and to induce clinical remission in 10 patients [55%]. Cumulative probability of remaining on anti-TNF therapy was 57.9% at 5 years among the 297 patients not starting an immunomodulator during follow-up. CONCLUSION: An immunomodulator was initiated in 15% of patients with Crohn's disease starting anti-TNF monotherapy. Independent predictors of immunomodulator initiation were infliximab use and second-/third-/fourth-line anti-TNF therapy. Resetting immunogenicity with an immunomodulator was effective in half of patients in a sub-study. Persistence of anti-TNF treatment at 5 years was observed in half of the 297 patients not starting an immumodulator in a real-life setting.
Disciplines :
Gastroenterology & hepatology
Author, co-author :
Peyrin-Biroulet, Laurent
Salleron, Julia
Filippi, Jerome
REENAERS, Catherine ;  Centre Hospitalier Universitaire de Liège - CHU > Service de gastroentérologie, hépatologie, onco. digestive
Antunes, Ophelie
Filipe, Virginie
Louis, Edouard  ;  Université de Liège > Département des sciences cliniques > Hépato-gastroentérologie
Hebuterne, Xavier
Roblin, Xavier
Language :
English
Title :
Anti-TNF Monotherapy for Crohn's Disease: a 13-year Multicentre Experience.
Publication date :
2016
Journal title :
Journal of Crohn's and Colitis
ISSN :
1873-9946
eISSN :
1876-4479
Publisher :
Elsevier, United Kingdom
Volume :
10
Issue :
5
Pages :
516-24
Peer reviewed :
Peer Reviewed verified by ORBi
Commentary :
Copyright (c) 2016 European Crohn's and Colitis Organisation (ECCO). Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.
Available on ORBi :
since 27 February 2017

Statistics


Number of views
70 (3 by ULiège)
Number of downloads
145 (0 by ULiège)

Scopus citations®
 
34
Scopus citations®
without self-citations
30
OpenCitations
 
26

Bibliography


Similar publications



Contact ORBi