Long-Term Outcomes Following Withdrawal of Anti-Tumour Necrosis Factor Treatment in Inflammatory Bowel Disease Patients in Remission: The Exit Long-Term Study of GETECCU.
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Casanova María José, Rubín de Célix Cristina, Riestra Sabino, Lucendo Alfredo J, Benítez José Manuel, Navarro-Llavat Mercè, Barrio Jesús, Morales-Alvarado Víctor J, Rivero Montserrat, Busquets David, Leo-Carnerero Eduardo, Nantes-Castillejo Oscar, Navarro Pablo, Van Domselaar Manuel, Gutiérrez-Casbas Ana, Alonso-Abreu Inmaculada, Barreiro-de Acosta Manuel, Fernández-Salazar Luis, Iborra Marisa, Martín-Arranz María Dolores, García-Morales Natalia, Guardiola Jordi, Bouhmidi-Assakali Abdel, Esteve María, Muñoz-Villafranca Carmen, Rodríguez-Lago Iago, Ceballos Daniel, Guerra Iván, Mañosa Miriam, Marín-Jiménez Ignacio, Vera-Mendoza Isabel, Garre Ana, Chaparro María, Gisbert Javier P, EXIT long‐term study group of GETECCU
Аннотация
AIMS: To compare the long-term risk of relapse between these groups and assess the response to anti-TNF resumption.
METHODS: This was a follow-up extension of the EXIT trial. We analysed long-term outcomes of patients in sustained clinical remission from the start of EXIT.
RESULTS: We included 125 patients (63 in MA and 62 in WA). Median follow-up was 12 months for MA and 26 months for WA. The cumulative incidence of relapse (95% CI) was 35% (23%-48%) in MA and 47% (34%-60%) in WA; p = 0.3. In MA, relapses occurred in 8% of patients by 12 months and 47% by 24 months. In WA, relapses occurred in 16% by 12 months and 39% by 24 months. The incidence rate of relapse per patient-year was 22% in MA and 19% in WA. Baseline faecal calprotectin > 250 μg/g was the only variable associated with a higher risk of relapse. Of the 29 patients who relapsed in WA, 26 (90%) resumed anti-TNF therapy; of these, 69% regained clinical remission.
CONCLUSION: In this extended analysis of patients included in the EXIT trial, withdrawing anti-TNF therapy in patients with IBD in remission was not associated with a higher long-term relapse risk.