Frequency and prognostic role of mucosal healing in patients with Crohn’s disease and ulcerative colitis after one-year of biological therapy

Farkas, Klaudia; Lakatos, László; Szűcs, Mónika; Pallagi-Kunstár, É.; Bálint, Anita; Nagy, Ferenc; Szepes, Zoltán; Vass, Noémi; Kiss, László; Wittmann, Tibor; Molnár, Tamás

doi:10.3748/wjg.v20.i11.2995

Cited by 36 publications

(20 citation statements)

References 24 publications

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“…Although retreatment with IFX due to relapse is effective and well tolerated, a relevant nonresponse rate of 19% in CD and 46% in ulcerative colitis was reported [23]. Our data demonstrate similar findings with comparable remission rates for CD patients treated with IFX [24].…”

Section: Discussionsupporting

confidence: 79%

“…Previous studies have suggested that the absence of mucosal healing at the time of discontinuation of biological therapy predicted a relapse [36]. However, it was recently demonstrated that mucosal healing does not predict "sustained" clinical remission if the biologicals are stopped after 1 year of treatment [23]. In our cohort, patients were evaluated for mucosal healing using colonoscopy before discontinuation if clinical and biochemical assessment indicated sustained clinical remission.…”

Section: Discussionmentioning

confidence: 99%

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Low Discontinuation Rate of Infliximab Treatment in Steroid-Dependent/Refractory Crohn’s Disease Patients

et al. 2017

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Background: Many patients with moderate to severe Crohn’s disease (CD) are treated with infliximab (IFX). As most of these patients experience a long-lasting therapy, the outcome and withdrawal of IFX treatment are important clinical questions. Methods: In this retrospective study, we analyzed the treatment outcome in moderate to severe CD patients with a steroid-dependent/refractory disease course started on IFX. Withdrawal of IFX was evaluated in patients with deep remission defined as clinical (Harvey-Bradshaw Index ≤4), biochemical (fecal calprotectin [FC] ≤150 μg/g stool) over a period of 2 years, and endoscopic and histological remission before discontinuation of IFX. Results: After induction with IFX, clinical remission was observed in 45/109 patients (41.3%) and clinical response in 61/109 patients (56.0%). Only 8/109 patients (7.3%) achieved deep remission and therefore could be discontinued from IFX therapy. In 4 of these patients (50%), relapse was observed after discontinuation of IFX treatment. FC decreased in these 8 patients in deep remission from 652 ± 168 μg/g stool (mean ± SE) at baseline to 24.9 ± 8.1 μg/g stool at 14 weeks. When compared to patients in deep remission, FC had decreased significantly less at 14 weeks in patients in clinical remission after induction with IFX (n = 31; 154 ± 55 μg/g stool; p = 0.01), in patients with clinical response after induction achieving clinical remission during the maintenance phase (n = 11; 352 ± 67 μg/g stool; p = 0.004), or in patients with chronic active disease course on maintenance therapy (n = 50; 645 ± 93 μg/g stool; p < 0.001). Conclusion: A low discontinuation rate was observed for steroid-dependent/refractory moderate to severe CD patients with IFX treatment. As FC showed a more or less pronounced decrease depending on the response to the IFX treatment, monitoring of FC may become a noninvasive tool for tailoring biological therapy in CD patients.

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Section: Discussionsupporting

confidence: 79%

Section: Discussionmentioning

confidence: 99%

Low Discontinuation Rate of Infliximab Treatment in Steroid-Dependent/Refractory Crohn’s Disease Patients

et al. 2017

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show abstract

“…Ya en la era previa a los bioló-gicos, los resultados de un estudio multicéntrico llevado a cabo por el grupo Ibsen demostraron que los pacientes con CM después de un año de tratamiento tenían menos actividad clínica y menor necesidad de tratamiento 16,17 , aunque otros estudios clínicos han encontrado resultados discordantes a este respecto 18 .…”

Section: Discussionunclassified

Evolución clínica tras la suspensión de infliximab en pacientes con colitis ulcerosa en remisión profunda

Villafranca

Rodríguez

Zárate

et al. 2016

Gastroenterología y Hepatología

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“…Il peut être utilisé en association avec les anti-TNF alpha pour augmenter leur efficacité en diminuant l'imunogénicité. Les anti-TNF alpha sont indiqués en traitement d'entretien pour les formes sévères ou en cas de corticorésistance ou corticodé-pendance [16][17][18]. Un bilan pré-thérapeutique complet est…”

Section: Maintien De La Rémissionunclassified

Rectocolite hémorragique : conduite diagnostique et prise en charge thérapeutique

et al. 2015

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Frequency and prognostic role of mucosal healing in patients with Crohn’s disease and ulcerative colitis after one-year of biological therapy

Abstract: Mucosal healing did not predict sustained clinical remission in patients in whom the biological therapies had been stopped.

Cited by 36 publications

References 24 publications

Low Discontinuation Rate of Infliximab Treatment in Steroid-Dependent/Refractory Crohn’s Disease Patients

Low Discontinuation Rate of Infliximab Treatment in Steroid-Dependent/Refractory Crohn’s Disease Patients

Evolución clínica tras la suspensión de infliximab en pacientes con colitis ulcerosa en remisión profunda

Rectocolite hémorragique : conduite diagnostique et prise en charge thérapeutique

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