The Crohn’s Disease-Ulcerative Colitis Clinical AppraisalPart II

Academic Content

Publication Overview Introduction Navigating this Publication See Part I

Step 1 -

Rationale and Definition

Step 2 -

International Clinician Survey Results

Step 3 -

Data Review and Faculty Summary

Step 4 -

International and Faculty Survey Comparison and Faculty Discussion

Step 5 -

Dr. Panaccione’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

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Clinical Gastroentrology and Hepatology

Dr. Panaccione’s Observed Future Directions

Additional randomized trials are needed to evaluate the long-term effects of discontinuing either the anti-TNF agent or IMM in patients who have achieved remission in CD. In particular, studies should focus on patients with early CD.

References

[1]

Vuitton L, Marteau P, Sandborn WJ, et al. IOIBD technical review on endoscopic indices for Crohn's disease clinical trials. Gut Doi: 10.1136/gutjnl-2015-309903. Published online ahead of print September 9, 2015.

[2]

Sandborn WJ, Hanauer S, Van Assche G, et al. Treating beyond symptoms with a view to improving patient outcomes in inflammatory bowel diseases. J Crohns Colitis 2014;8:927-935.

[3]

Moss AC, Kim KJ, Fernandez-Becker N, et al. Impact of concomitant immunomodulator use on long-term outcomes in patients receiving scheduled maintenance infliximab. Dig Dis Sci. 2010;55:1413-1420.

[4]

Renna S, Cottone M, Orlando A. Optimization of the treatment with immunosuppressants and biologics in inflammatory bowel disease. World J Gastroenterol. 2014;20:9675-9690.

[5]

Colombel JF, Sandborn WJ, Reinisch W, et al; SONIC Study Group. Infliximab, azathioprine, or combination therapy for Crohn's disease. N Engl J Med. 2010;362:1383-1395.

[6]

Xu Z, Davis HM, Zhou H. Clinical impact of concomitant immunomodulators on biologic therapy: Pharmacokinetics, immunogenicity, efficacy and safety. J Clin Pharmacol. 2015;55(Suppl 3):S60-S74.

[7]

Pittet V, Froehlich F, Maillard MH, et al; EPACT-II Update Panellists. When do we dare to stop biological or immunomodulatory therapy for Crohn's disease? Results of a multidisciplinary European expert panel. J Crohns Colitis 2013;7:820-826.

[8]

Molnar T, Lakatos PL, Farkas K, et al. Predictors of relapse in patients with Crohn's disease in remission after 1 year of biological therapy. Aliment Pharmacol Ther. 2013;37:225-233.

[9]

Lemann M, Mary JY, Duclos B, et al. Infliximab plus azathioprine for steroid-dependent Crohn's disease patients: a randomized placebo-controlled trial. Gastroenterology 2006;130:1054-1061.

[10]

Van Assche G, Magdelaine-Beuzelin C, D'Haens G, et al. Withdrawal of immunosuppression in Crohn's disease treated with scheduled infliximab maintenance: a randomized trial. Gastroenterology 2008;134:1861-1868.

[11]

Baert F, Noman M, Vermeire S, et al. Influence of immunogenicity on the long-term efficacy of infliximab in Crohn's disease. N Engl J Med. 2003;348:601-608.

[12]

Vermeire S, Noman M, Van Assche G, et al. Effectiveness of concomitant immunosuppressive therapy in suppressing the formation of antibodies to infliximab in Crohn's disease. Gut 2007;56:1226-1231.

[13]

Louis E, Mary JY, Vernier-Massouille G, et al; Groupe D'etudes Thérapeutiques Des Affections Inflammatoires Digestives.. Maintenance of remission among patients with Crohn's disease on antimetabolite therapy after infliximab therapy is stopped. Gastroenterology 2012;142:63-70.

[14]

Biancone L, De Nigris F, Del Vecchio Blanco G, et al. Review article: monitoring the activity of Crohn's disease. Aliment Pharmacol Ther. 2002;16(Suppl 4):29-33.

[15]

Oussalah A, Chevaux JB, Fay R, et al. Predictors of infliximab failure after azathioprine withdrawal in Crohn's disease treated with combination therapy. Am J Gastroenterol. 2010;105:1142-1149.

[16]

Sokol H, Seksik P, Carrat F, et al. Usefulness of co-treatment with immunomodulators in patients with inflammatory bowel disease treated with scheduled infliximab maintenance therapy. Gut 2010;59:1363-1368.

[17]

Reenaers C, Louis E, Belaiche J, et al. Does co-treatment with immunosuppressors improve outcome in patients with Crohn's disease treated with adalimumab? Aliment Pharmacol Ther. 2012;36:1040-1048.

[18]

Papay P, Ignjatovic A, Karmiris K, et al. Optimising monitoring in the management of Crohn's disease: A physician's perspective. J Crohns Colitis 2013;7:653-669.

[19]

Siegel CA, Finlayson SR, Sands BE, et al. Adverse events do not outweigh benefits of combination therapy for Crohn's disease in a decision analytic model. Clin Gastroenterol Hepatol. 2012;10:46-51.

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