The level of remission in patients with remitting IBD appears to play a major role in whether they will relapse after treatment with biologic therapies is discontinued, according to a new prospective study. GastroTwitter
However, analysis showed that partial endoscopic healing was independently associated with a higher risk of relapse, at an adjusted hazard ratio vs complete endoscopic healing of 3.28.
Of the patients who relapsed, 75% restarted anti-TNF treatment, and the majority were restarted on the same agent at a median of 0.9 years since its withdrawal, and a median of 24 days since the onset of relapse. "What is also relevant, but was not evaluated, is the additional endpoint of histologic healing, which is likely to sustain remissions even longer," he added.
Although the study didn't clear up that question for Regueiro, he found it compelling that mesalamine continuation resulted in higher rates of sustained remission after anti-TNF withdrawal among patients with ulcerative colitis.
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