C Gagniere1, L Beaugerie1, B Pariente2, P Seksik1, A Amiot3, V Abitbol4, M Allez2, J Cosnes1, H Sokol5. 1. Department of Gastroenterology, Saint Antoine Hospital, Assistance Publique Hôpitaux de Paris and Paris VI University, Paris, France. 2. Department of Gastroenterology, Saint Louis Hospital, Assistance Publique Hôpitaux de Paris and Paris VII University, Paris, France. 3. Department of Gastroenterology, Henri Mondor Hospital, Assistance Publique Hôpitaux de Paris and Paris XII University, Paris, France. 4. Department of Gastroenterology, Cochin Hospital, Assistance Publique Hôpitaux de Paris and Paris V University, Paris, France. 5. Department of Gastroenterology, Saint Antoine Hospital, Assistance Publique Hôpitaux de Paris and Paris VI University, Paris, France harry.sokol@sat.aphp.fr.
Abstract
BACKGROUND: Infliximab [IFX] and adalimumab [ADA] are effective in Crohn's disease [CD] for induction and maintenance therapy. However, high annual rate of discontinuation for loss of response or intolerance may lead to a switch to another anti-tumor necrosis factor agent. Patients with successive failure to IFX and ADA are becoming more frequent. The aim of this study was to assess the efficacy and the tolerance of re-treatment with IFX in CD patients who successively failed IFX and ADA. METHODS: A total of 61 patients with CD who received and discontinued successively IFX and ADA, and who were re-exposed to IFX, were identified in four French tertiary centers and retrospectively analyzed. Clinical data, follow-up and outcome were abstracted from medical records. RESULTS: Median treatment duration after reintroduction was 16 months, and probability of remaining under IFX was 60% and 51%, respectively, at 12 and 24 months. In all 29 patients discontinued the second IFX treatment due to intolerance [13], primary non-response [8], loss of response [7] or patient's wish [1]. Remission was achieved in 42% at week 6-8 after IFX re-induction, and was predictive of better long-term response [p = 0.006]. In multivariate analysis, receiving co-immunosuppression in both first and second IFX treatments [p = 0.04] and shorter interval between first and second IFX treatments [p = 0.017] were independently associated with longer duration of second IFX treatment. CONCLUSION: For CD patients who successively failed IFX and ADA, reintroducing IFX is feasible and often clinically efficient, particularly in patients who received co-immunosuppression during both first and second IFX treatments.
BACKGROUND:Infliximab [IFX] and adalimumab [ADA] are effective in Crohn's disease [CD] for induction and maintenance therapy. However, high annual rate of discontinuation for loss of response or intolerance may lead to a switch to another anti-tumornecrosis factor agent. Patients with successive failure to IFX and ADA are becoming more frequent. The aim of this study was to assess the efficacy and the tolerance of re-treatment with IFX in CDpatients who successively failed IFX and ADA. METHODS: A total of 61 patients with CD who received and discontinued successively IFX and ADA, and who were re-exposed to IFX, were identified in four French tertiary centers and retrospectively analyzed. Clinical data, follow-up and outcome were abstracted from medical records. RESULTS: Median treatment duration after reintroduction was 16 months, and probability of remaining under IFX was 60% and 51%, respectively, at 12 and 24 months. In all 29 patients discontinued the second IFX treatment due to intolerance [13], primary non-response [8], loss of response [7] or patient's wish [1]. Remission was achieved in 42% at week 6-8 after IFX re-induction, and was predictive of better long-term response [p = 0.006]. In multivariate analysis, receiving co-immunosuppression in both first and second IFX treatments [p = 0.04] and shorter interval between first and second IFX treatments [p = 0.017] were independently associated with longer duration of second IFX treatment. CONCLUSION: For CDpatients who successively failed IFX and ADA, reintroducing IFX is feasible and often clinically efficient, particularly in patients who received co-immunosuppression during both first and second IFX treatments.
Authors: Vito Annese; Rahul Nathwani; Maryam Alkhatry; Ahmad Al-Rifai; Sameer Al Awadhi; Filippos Georgopoulos; Ahmad N Jazzar; Ahmed M Khassouan; Zaher Koutoubi; Mazen S Taha; Jimmy K Limdi Journal: Therap Adv Gastroenterol Date: 2021-12-22 Impact factor: 4.409
Authors: Laurent Goessens; Jean-Frédéric Colombel; An Outtier; Marc Ferrante; Joao Sabino; Ciaran Judge; Reza Saeidi; Louise Rabbitt; Alessandro Armuzzi; Eugeni Domenech; George Michalopoulos; Anneline Cremer; Francisco Javier García-Alonso; Tamas Molnar; Konstantinos Karmiris; Krisztina Gecse; Joep Van Oostrom; Mark Löwenberg; Klaudia Farkas; Raja Atreya; Davide Giuseppe Ribaldone; Christian Selinger; Frank Hoentjen; Benoit Bihin; Shaji Sebastian; Jean-François Rahier Journal: United European Gastroenterol J Date: 2021-10-25 Impact factor: 4.623