Long-term Outcomes after the Discontinuation of Anti-Tumor Necrosis Factor-α Therapy in Patients with Inflammatory Bowel Disease under Clinical Remission: A Korean Association for the Study of Intestinal Disease Multicenter Study
DC Field | Value | Language |
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dc.contributor.author | Song, Joo Hye | - |
dc.contributor.author | Kang, Eun Ae | - |
dc.contributor.author | Park, Soo-Kyung | - |
dc.contributor.author | Hong, Sung Noh | - |
dc.contributor.author | Kim, You Sun | - |
dc.contributor.author | Bang, Ki Bae | - |
dc.contributor.author | Kim, Kyeong Ok | - |
dc.contributor.author | Lee, Hong Sub | - |
dc.contributor.author | Kang, Sang-Bum | - |
dc.contributor.author | Shin, Seung Yong | - |
dc.contributor.author | Song, Eun Mi | - |
dc.contributor.author | Im, Jong Pil | - |
dc.contributor.author | Choi, Chang Hwan | - |
dc.date.accessioned | 2021-09-29T00:40:25Z | - |
dc.date.available | 2021-09-29T00:40:25Z | - |
dc.date.issued | 2021-09 | - |
dc.identifier.issn | 1976-2283 | - |
dc.identifier.issn | 2005-1212 | - |
dc.identifier.uri | https://scholarworks.bwise.kr/cau/handle/2019.sw.cau/49959 | - |
dc.description.abstract | Background/Aims: Our study aimed to evaluate the long-term outcomes and risk factors for relapse after anti-tumor necrosis factor (TNF)-α cessation in inflammatory bowel disease (IBD) patients because they are not well established. Methods: A retrospective multicenter cohort study was conducted involving patients with Crohn’s disease (CD) or ulcerative colitis (UC) from 10 referral hospitals in Korea who discontinued firstline anti-TNF therapy after achieving clinical remission. Results: A total of 109 IBD patients (71 CD and 38 UC) with a median follow-up duration of 56 months were analyzed. The cumulative relapse rates at 1, 3, and 5 years were 11.3%, 46.7%, and 62.5% for CD patients and 28.9%, 45.3%, and 60.9% for UC patients. Multivariable Cox analysis revealed that discontinuation owing to the clinician’s decision was associated with lower risk of relapse (vs patient’s preference: hazard ratio [HR], 0.13; 95% confidence interval [CI], 0.04 to 0.48; p=0.002) and adalimumab use was associated with higher risk of relapse (vs infliximab: HR, 4.42; 95% CI, 1.24 to 17.74; p=0.022) in CD patients. Mucosal healing was associated with lower risk of relapse (vs nonmucosal healing: HR, 0.12; 95% CI, 0.02 to 0.83; p=0.031) in UC patients. Anti-TNF re-induction was provided to 52 patients, and a response was obtained in 50 patients. However, 25 of them discontinued retreatment owing to a loss of response (n=15), the patient’s preference (n=6), and other factors (n=4). Conclusions: More than 60% of IBD patients in remission under anti-TNF therapy relapsed within 5 years of treatment cessation. Anti-TNF re-induction was effective. However, half of the patients discontinued anti-TNF therapy, and 50% of these patients discontinued treatment owing to loss of response. | - |
dc.format.extent | 11 | - |
dc.language | 영어 | - |
dc.language.iso | ENG | - |
dc.publisher | 거트앤리버 소화기연관학회협의회 | - |
dc.title | Long-term Outcomes after the Discontinuation of Anti-Tumor Necrosis Factor-α Therapy in Patients with Inflammatory Bowel Disease under Clinical Remission: A Korean Association for the Study of Intestinal Disease Multicenter Study | - |
dc.title.alternative | Long-term Outcomes after the Discontinuation of Anti-Tumor Necrosis Factor-α Therapy in Patients with Inflammatory Bowel Disease under Clinical Remission: A Korean Association for the Study of Intestinal Disease Multicenter Study | - |
dc.type | Article | - |
dc.identifier.doi | 10.5009/gnl20233 | - |
dc.identifier.bibliographicCitation | Gut and Liver, v.15, no.5, pp 752 - 762 | - |
dc.identifier.kciid | ART002755552 | - |
dc.description.isOpenAccess | N | - |
dc.identifier.wosid | 000736815600005 | - |
dc.identifier.scopusid | 2-s2.0-85115226501 | - |
dc.citation.endPage | 762 | - |
dc.citation.number | 5 | - |
dc.citation.startPage | 752 | - |
dc.citation.title | Gut and Liver | - |
dc.citation.volume | 15 | - |
dc.type.docType | Article | - |
dc.publisher.location | 대한민국 | - |
dc.subject.keywordAuthor | Inflammatory bowel diseases | - |
dc.subject.keywordAuthor | Tumor necrosis factor inhibitors | - |
dc.subject.keywordAuthor | Withholding treatment | - |
dc.subject.keywordAuthor | Recurrence | - |
dc.subject.keywordPlus | ANTI-TNF DISCONTINUATION | - |
dc.subject.keywordPlus | CROHNS-DISEASE | - |
dc.subject.keywordPlus | ULCERATIVE-COLITIS | - |
dc.subject.keywordPlus | INFLIXIMAB THERAPY | - |
dc.subject.keywordPlus | MAINTENANCE | - |
dc.subject.keywordPlus | RELAPSE | - |
dc.subject.keywordPlus | RISK | - |
dc.subject.keywordPlus | PREDICTORS | - |
dc.subject.keywordPlus | MANAGEMENT | - |
dc.subject.keywordPlus | INFECTION | - |
dc.relation.journalResearchArea | Gastroenterology & Hepatology | - |
dc.relation.journalWebOfScienceCategory | Gastroenterology & Hepatology | - |
dc.description.journalRegisteredClass | scie | - |
dc.description.journalRegisteredClass | scopus | - |
dc.description.journalRegisteredClass | kci | - |
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