Back to Search
Start Over
Anti-TNF Treatment for Extraintestinal Manifestations of Inflammatory Bowel Disease in the Swiss IBD Cohort Study.
- Source :
-
Inflammatory bowel diseases [Inflamm Bowel Dis] 2017 Jul; Vol. 23 (7), pp. 1174-1181. - Publication Year :
- 2017
-
Abstract
- Background: Extraintestinal manifestations (EIMs) in patients with inflammatory bowel disease (IBD) are frequently observed. Little is known about the efficacy of anti-tumor necrosis factor (TNF) in EIM management. We assessed the effect of 3 anti-TNF agents (infliximab, adalimumab, and certolizumab pegol) on EIM evolution.<br />Methods: Data on 1249 patients from the Swiss IBD Cohort Study (SIBDCS) were analyzed. All EIMs were diagnosed by relevant specialists. Response was classified into improvement, stable disease, and clinical worsening based on the physician's interpretation.<br />Results: Of the 366 patients with at least 1 EIM, 213 (58.2%) were ever treated with an anti-TNF. A total of 299 treatments were started for 355 EIMs. Patients with EIM were significantly more often treated with anti-TNF compared with those without EIM (58.2% versus 21.0%, P < 0.001). Infliximab was the most frequently used drug (63.2%). In more than 71.8%, a clinical response of the underlying EIM to anti-TNF therapy was observed. In 92 patients (43.2%), anti-TNF treatments were started for the purpose of treating EIM rather than IBD. Response rates to anti-TNF were generally good and best for psoriasis, aphthous stomatitis, uveitis, and peripheral arthritis. In 11 patients, 14 EIM occurred under anti-TNF treatment.<br />Conclusions: Anti-TNF was frequently used among patients with EIM. In more than 40%, anti-TNF treatments are started to treat EIM rather than IBD. Given the good response rates, anti-TNF seems to be a valuable option in the treatment of EIM, whereas appearance of EIM under anti-TNF does not seem to be a source of considerable concern.
- Subjects :
- Adalimumab therapeutic use
Adolescent
Adult
Aged
Arthritis immunology
Arthritis pathology
Certolizumab Pegol therapeutic use
Child
Child, Preschool
Female
Follow-Up Studies
Humans
Inflammatory Bowel Diseases immunology
Inflammatory Bowel Diseases pathology
Infliximab therapeutic use
Male
Middle Aged
Prognosis
Stomatitis, Aphthous immunology
Stomatitis, Aphthous pathology
Young Adult
Arthritis drug therapy
Immunosuppressive Agents therapeutic use
Inflammatory Bowel Diseases drug therapy
Stomatitis, Aphthous drug therapy
Tumor Necrosis Factor-alpha immunology
Subjects
Details
- Language :
- English
- ISSN :
- 1536-4844
- Volume :
- 23
- Issue :
- 7
- Database :
- MEDLINE
- Journal :
- Inflammatory bowel diseases
- Publication Type :
- Academic Journal
- Accession number :
- 28452862
- Full Text :
- https://doi.org/10.1097/MIB.0000000000001109