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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

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dc.contributor.author강은애-
dc.date.accessioned2022-11-24T00:34:06Z-
dc.date.available2022-11-24T00:34:06Z-
dc.date.issued2021-09-
dc.identifier.issn1976-2283-
dc.identifier.urihttps://ir.ymlib.yonsei.ac.kr/handle/22282913/190776-
dc.description.abstractBackground/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.description.statementOfResponsibilityopen-
dc.formatapplication/pdf-
dc.languageEnglish-
dc.publisherEditorial Office of Gut and Liver-
dc.relation.isPartOfGUT AND LIVER-
dc.rightsCC BY-NC-ND 2.0 KR-
dc.subject.MESHAdalimumab-
dc.subject.MESHCohort Studies-
dc.subject.MESHColitis, Ulcerative* / drug therapy-
dc.subject.MESHHumans-
dc.subject.MESHInflammatory Bowel Diseases* / drug therapy-
dc.subject.MESHInfliximab-
dc.subject.MESHRemission Induction-
dc.subject.MESHRepublic of Korea-
dc.subject.MESHRetrospective Studies-
dc.subject.MESHTumor Necrosis Factor Inhibitors-
dc.subject.MESHTumor Necrosis Factor-alpha-
dc.titleLong-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.typeArticle-
dc.contributor.collegeCollege of Medicine (의과대학)-
dc.contributor.departmentDept. of Internal Medicine (내과학교실)-
dc.contributor.googleauthorJoo Hye Song-
dc.contributor.googleauthorEun Ae Kang-
dc.contributor.googleauthorSoo-Kyung Park-
dc.contributor.googleauthorSung Noh Hong-
dc.contributor.googleauthorYou Sun Kim-
dc.contributor.googleauthorKi Bae Bang-
dc.contributor.googleauthorKyeong Ok Kim-
dc.contributor.googleauthorHong Sub Lee-
dc.contributor.googleauthorSang-Bum Kang-
dc.contributor.googleauthorSeung Yong Shin-
dc.contributor.googleauthorEun Mi Song-
dc.contributor.googleauthorJong Pil Im-
dc.contributor.googleauthorChang Hwan Choi-
dc.identifier.doi10.5009/gnl20233-
dc.contributor.localIdA05966-
dc.relation.journalcodeJ00954-
dc.identifier.eissn2005-1212-
dc.identifier.pmid33767028-
dc.subject.keywordInflammatory bowel diseases-
dc.subject.keywordRecurrence-
dc.subject.keywordTumor necrosis factor inhibitors-
dc.subject.keywordWithholding treatment-
dc.contributor.alternativeNameKang, Eun Ae-
dc.contributor.affiliatedAuthor강은애-
dc.citation.volume15-
dc.citation.number5-
dc.citation.startPage752-
dc.citation.endPage762-
dc.identifier.bibliographicCitationGUT AND LIVER, Vol.15(5) : 752-762, 2021-09-
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers

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