Relapse Common in IBD Patients Who Stop Anti-TNF Therapy, But Can Take Years, Study Finds

Relapse Common in IBD Patients Who Stop Anti-TNF Therapy, But Can Take Years, Study Finds
Nearly half of the more than 1,000 people with inflammatory bowel disease (IBD) in clinical remission had a relapse some three years after stopping anti-tumor necrosis factor (anti-TNF) treatment — and more than half relapsed at five years, a retrospective study reported. But a "top-down" treatment approach seemed to reduce relapse risk, and the long remission period seen led the researchers to suggest that decisions should be left to the patient and doctor. The study, “Evolution After Anti-TNF Discontinuation in Patients With Inflammatory Bowel Disease: A Multicenter Long-Term Follow-Up Study," was published in the American Journal of Gastroenterology. IBD, which includes Crohn’s disease and ulcerative colitis, has a natural course characterized by alternating periods of remission and relapse, with flares random and largely unpredictable. The introduction of anti-TNF antibodies has dramatically improved the quality of life for these patients. But questions remain: What happens to IBD patients when they discontinue this treatment, and what factors predict a relapse? To answer these, Javier P. Gisbert, MD, PhD, with the department of gastroenterology at La Princesa University Hospital in Madrid, and his colleagues evaluated 1,055 IBD patients who had been treated with the anti-TNF drugs Humira (adalimumab, AbbVie) or Remicade (infliximab, Janssen). All had stopped the treatment after achieving clinical remission. “Currently available data are insufficient to make recommendations on when, if ever, anti-TNF therapy can be sto
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