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1. Treatment patterns and intensification within 5 year of follow-up of the first-line anti-TNFα used for the treatment of IBD: Results from the VERNE study.

Author

Bastida, G., Marín-Jiménez, I., Forés, A., García-Planella, E., Argüelles-Arias, F., Tagarro, I., Fernandez-Nistal, A., Montoto, C., Aparicio, J., Aguas, M., Santos-Fernández, J., Boscá-Watts, M.M., Ferreiro-Iglesias, R., Merino, O., Aldeguer, X., Cortés, X., Sicilia, B., Mesonero, F., and Barreiro-de Acosta, M.

Abstract

Anti-TNFα represent one of the main treatment approaches for the management of inflammatory bowel diseases (IBD). Therefore,the evaluation of their treatment patterns over time provides valuable insights about the clinical value of therapies and associated costs. To assess the treatment patterns with the first anti-TNFα in IBD. Retrospective, observational study. 310 IBD patients were analyzed along a 5-year follow-up period. 56.2% of Crohn's disease (CD) patients started with adalimumab (ADA), while 43.8% started with infliximab (IFX). 12.9% of ulcerative colitis (UC) patients initiated with ADA, while 87.1% initiated with IFX. Treatment intensification was required in 28.9% of CD and 37.1% of UC patients. Median time to treatment intensification was shorter in UC than in CD (5.3 vs. 14.3 months; p = 0.028). Treatment discontinuation due to reasons other than remission were observed in 40.7% of CD and 40.5% of UC patients, although, in UC patients there was a trend to lower discontinuation rates with IFX (36.6%) than with ADA (66.7%). Loss of response accounted for approximately one-third of discontinuations, in both CD and UC. Around one-third of IBD biologic-naive patients treated with an anti-TNFα required treatment intensification (earlier in UC) and around 40% discontinued the anti-TNFα due to inappropriate disease control. [ABSTRACT FROM AUTHOR]

Published
2022
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2. Evolution After Anti-TNF Discontinuation in Patients With Inflammatory Bowel Disease: A Multicenter Long-Term Follow-Up Study

Author

Casanova, M J, Chaparro, M, García-Sánchez, V, Nantes, O, Leo, E, Rojas-Feria, M, Jauregui-Amezaga, A, García-López, S, Huguet, J M, Arguelles-Arias, F, Aicart, M, Marín-Jiménez, I, Gómez-García, M, Muñoz, F, Esteve, M, Bujanda, L, Cortés, X, Tosca, J, Pineda, J R, Mañosa, M, Llaó, J, Guardiola, J, Pérez-Martínez, I, Muñoz, C, González-Lama, Y, Hinojosa, J, Vázquez, J M, Martinez-Montiel, M P, Rodríguez, G E, Pajares, R, García-Sepulcre, M F, Hernández-Martínez, A, Pérez-Calle, J L, Beltrán, B, Busquets, D, Ramos, L, Bermejo, F, Barrio, J, Barreiro-de Acosta, M, Roncedo, O, Calvet, X, Hervías, D, Gomollón, F, Domínguez-Antonaya, M, Alcaín, G, Sicilia, B, Dueñas, C, Gutiérrez, A, Lorente-Poyatos, R, Domínguez, M, Khorrami, S, Muñoz, C, Taxonera, C, Rodríguez-Pérez, A, Ponferrada, A, Van Domselaar, M, Arias-Rivera, M L, Merino, O, Castro, E, Marrero, J M, Martín-Arranz, M, Botella, B, Fernández-Salazar, L, Monfort, D, Opio, V, García-Herola, A, Menacho, M, Ramírez-de la Piscina, P, Ceballos, D, Almela, P, Navarro-Llavat, M, Robles-Alonso, V, Vega-López, A B, Moraleja, I, Novella, M T, Castaño-Milla, C, Sánchez-Torres, A, Benítez, J M, Rodríguez, C, Castro, L, Garrido, E, Domènech, E, García-Planella, E, and Gisbert, J P

Abstract

OBJECTIVES:The aims of this study were to assess the risk of relapse after discontinuation of anti-tumor necrosis factor (anti-TNF) drugs in patients with inflammatory bowel disease (IBD), to identify the factors associated with relapse, and to evaluate the overcome after retreatment with the same anti-TNF in those who relapsed.METHODS:This was a retrospective, observational, multicenter study. IBD patients who had been treated with anti-TNFs and in whom these drugs were discontinued after clinical remission was achieved were included.RESULTS:A total of 1,055 patients were included. The incidence rate of relapse was 19% and 17% per patient-year in Crohn’s disease and ulcerative colitis patients, respectively. In both Crohn’s disease and ulcerative colitis patients in deep remission, the incidence rate of relapse was 19% per patient-year. The treatment with adalimumab vs. infliximab (hazard ratio (HR)=1.29; 95% confidence interval (CI)=1.01–1.66), elective discontinuation of anti-TNFs (HR=1.90; 95% CI=1.07–3.37) or discontinuation because of adverse events (HR=2.33; 95% CI=1.27–2.02) vs. a top-down strategy, colonic localization (HR=1.51; 95% CI=1.13–2.02) vs. ileal, and stricturing behavior (HR=1.5; 95% CI=1.09–2.05) vs. inflammatory were associated with a higher risk of relapse in Crohn’s disease patients, whereas treatment with immunomodulators after discontinuation (HR=0.67; 95% CI=0.51–0.87) and age (HR=0.98; 95% CI=0.97–0.99) were protective factors. None of the factors were predictive in ulcerative colitis patients. Retreatment of relapse with the same anti-TNF was effective (80% responded) and safe.CONCLUSIONS:The incidence rate of inflammatory bowel disease relapse after anti-TNF discontinuation is relevant. Some predictive factors of relapse after anti-TNF withdrawal have been identified. Retreatment with the same anti-TNF drug was effective and safe.

Published
2017
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3. Recomendaciones del Grupo Español de Trabajo en Enfermedad de Crohn y Colitis Ulcerosa (GETECCU) sobre el tratamiento de pacientes con espondiloartritis asociada a enfermedad inflamatoria intestinal

Author

González-Lama, Y., Sanz, J., Bastida, G., Campos, J., Ferreiro, R., Joven, B., Gutiérrez, A., Juanola, X., Sicilia, B., Veroz, R., Gisbert, J.P., Chaparro, M., Domènech, E., Esteve, M., and Gomollón, F.

Abstract

Las manifestaciones extraintestinales en general y, de entre ellas, las articulares en particular, suponen un problema frecuente en los pacientes con enfermedad inflamatoria intestinal. De hecho, la relación entre ambas entidades parece estrecha y cada vez hay más datos que indican que el intestino desempeña un importante papel en la patogenia de las espondiloartritis. La asociación de la enfermedad inflamatoria intestinal con algún tipo de espondiloartritis supone un escenario clínico complejo. Se hace necesario, por tanto, que gastroenterólogos y reumatólogos puedan trabajar juntos y establecer una comunicación fluida que permita a cada paciente recibir el tratamiento más adecuado para cada situación concreta. El objetivo de esta revisión es el de establecer unas recomendaciones sobre el tratamiento de los pacientes con enfermedad inflamatoria intestinal y espondiloartritis asociada, en cada uno de los distintos escenarios clínicos.

Published
2017
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4. Risk factors for ulcerative colitis: A population-based, case–control study in Spain.

Author

Sicilia, B., Arribas, F., Nerín, J., López Miguel, C., Vicente, R., and Gomollón, F.

Subjects
ULCERATIVE colitis, MULTIVARIATE analysis, LOGISTIC regression analysis
Abstract

Abstract: Background: Environmental factors seem to be very important in the aetiology of Ulcerative Colitis (UC), with smoking, contraceptive use, and hygiene being the factors most commonly linked to disease. Aim: To analyse the association between different risk factors and development of UC in our community. Patients and methods: This is a case–control, population-based study. The UC population consists of an inception-case population of all cases diagnosed, using Lennard–Jones criteria, in our community from 1st February 1992 to 31st January 1995 that were prospectively included. Controls were selected from healthy population and matched with patients for age, sex and rural/urban habitat. We used the SPSS/PC+ software, EpiInfo and Statistix for statistical analysis, giving the rates as point estimates and 95% confidence intervals (95%CI) or as mean±standard deviation in quantitative variables. For multivariate analysis we used conditional logistic regression. Results: 205 patients were diagnosed of UC. 38 patients (18.5%) with UC were smokers, compared with 84 (40.8%) controls (p <0.001). Smoking behaved as a protector factor for UC (OR=0.55 (CI 95% 0.33–0.92) and ex-smoker acted as a risk factor (OR=1.94 (CI 95% 1.14–3.34). After the multivariate analysis, both associations were maintained. We did not detect statistical differences in the analysis of previous appendectomy, childhood hygiene or oral contraceptive use. Five of the 12 cases with family aggregation had first-degree relatives and 7 of them second-degree relatives. None of the controls had previous IBD history (p =0.0002). Conclusion: Ex-smoking and previous family history of inflammatory bowel disease appeared as risk factors for developing ulcerative colitis while current smoking behaved as a protective factor in this population. [Copyright &y& Elsevier]

Published
2008
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5. La afectación pancolónica inicial en la colitis ulcerosa predice la necesidad de colectomía: estudio poblacional basado en una cohorte incidente de pacientes en Aragón

Author

Sicilia, B., Vicente, R., Arroyo, M.T., Arribas, F., and Gomollón, F.

Abstract

Sobre la base de estudios poblacionales, la única variable clínica consistente y predictiva de un determinado curso clínico que se ha descrito es el mayor riesgo de colectomía en los pacientes con pancolitis ulcerosa.

Published
2005
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7. Recomendaciones del Grupo Español de Trabajo en Enfermedad de Crohn y Colitis Ulcerosa (GETECCU) sobre cribado de displasia en pacientes con enfermedad inflamatoria intestinal

Author

Sicilia, B., Vicente, R., Arias, L., Echarri, A., Zabana, Y., Mañosa, M., Beltrán, B., and Barreiro-de Acosta, M.

Abstract

Los pacientes con enfermedades inflamatorias intestinales de localización colónica tienen mayor riesgo de desarrollar cáncer colorrectal que la población general, por lo que precisan de técnicas endoscópicas de cribado con intervalos de seguimiento basados en los diferentes factores de riesgo descritos.

Published
2021
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