Treatment of Inflammatory Bowel Disease with Biologics

14 4

Table 10.1

Studies on the withdrawal of anti-TNF-

α therapies

Authors

Number of participants (

n)

Study design

Relapse rate

Significant predictors of relapse

Predictors evaluated but not found to be significant

Recapture rate

CD

Brooks et al. [^52

]

86

Prospective observational

4.7% (3 months)

Ileocolonic disease

Age, gender, disease behavior, previous surgical resection, immunosuppression at start of anti-TNF-

α treatment,

disease duration, dose escalation of anti-TNF-

α^

agent, concomitant IMM, raised CRP

93%

18.6% (6 months)

Previous anti-TNF-

α^

treatment

(88% concomitant IMM)

36% (1 year)

Raised fecal calprotectin

Domenech et al. [

42

]

23

Prospective observational (69% with concomitant IMM)

31% (1 year)

Perianal disease

Gender, smoking status, previous treatment with IFX, concomitant IMM, location, development of infusion acute reactions

• 
  

66% (1 year) for perianal disease

Louis et al. (STORI) [

41

]

115

Prospective observational (100% with concomitant IMM)

43.9% (1 year)

Male, absence of surgical resection, elevated leucocyte count >6.0 × 10

9 /L,

hemoglobin ≤ 145 g/L

Age, smoking status, location, previous resection, disease duration, treatment duration

88%

15% (1 year) for those with ≤2 predictors of relapse

C-reactive protein ≥5.0 mg/LFecal calprotectin ≥ 300 μg/g

Reenaers et al. (long-term follow-up of STORI trial) [^77

]

102/115 (long-term outcome)

Prospective observational (100% with concomitant IMM)

85% (median 8 years)

Upper GI involvement

Not reported (only abstract is available)

40%

Elevated leucocyte count > 6.0 × 10

9 /L

H.H. Shim and C.H. Seow