The Crohn’s Disease-Ulcerative Colitis Clinical AppraisalPart II – Emerging trends in clinical practice

The Crohn’s Disease-Ulcerative Colitis Clinical Appraisal
Part II – Emerging trends in clinical practice

Statement 7: Combination therapy with an anti-tumor necrosis factor-α agent and an immunomodulator increases the risk of serious infections or malignancy relative to anti-tumor necrosis factor-α monotherapy in inflammatory bowel disease.

Laurent Peyrin-Biroulet, MD, PhD

Academic Content

Publication Overview Introduction Navigating this Publication See Part I

Rationale and Definition

International Clinician Survey Results

Data Review and Faculty Summary

International and Faculty Survey Comparison and Faculty Discussion

Dr. Peyrin-Biroulet’s Observed Future Directions and References

Faculty Presentations

Statement 1 Statement 2 Statements
3a and 3b Statement 4 Statement 5 Statement 6 Statement 7 Statement 8

Download Printable Transcript

Clinical Gastroentrology and Hepatology

See Statements:

1

2

3

4

5

6

7

8

Statement 7 Steps:

1 2 3 4 5

Reader: Please indicate your degree of support for Statement 7 on the following scale:

Agree completely
Agree with minor reservations
Agree with major reservations
Reject with reservations
Reject completely

Statement Rationale and Definition

Combination therapy with an anti-tumor necrosis factor-α (anti-TNF) agent and a thiopurine is more effective than anti-TNF monotherapy for inflammatory bowel disease (IBD) treatment, although this issue has only been addressed in clinical trials to date with infliximab (IFX) .¹ Combination therapy is associated with safety concerns that include risk of malignancy.² Whether this increased malignancy risk is mainly related to thiopurine use or can be attributed to an additive effect of combining anti-TNF therapy and thiopurine treatment remains an issue of debate. Conducting a risk-benefit analysis of combination therapy with anti-TNF agents and anti-TNF monotherapy is imperative to successful clinical management of IBD.²