How to Manage Inflammatory Bowel Disease Patients When They Withdraw Anti-Tumour Necrosis Factor [Anti-TNF] Due to Severe Anti-TNF-Induced Skin Lesions? A Multicentre Cohort Study.
Cottron, C; Treton, X; Altwegg, Ret al.
2022 • In Journal of Crohn's and Colitis, 16 (8), p. 1202-1210
[en] BACKGROUND AND AIMS: Optimal management of patients with inflammatory bowel disease [IBD] after anti-tumour necrosis factor [TNF] discontinuation due to severe induced skin lesions is unclear. Our study aimed to describe dermatological and IBD evolution after anti-TNF discontinuation for this side effect. METHODS: We conducted a multicentre retrospective study including consecutive IBD patients who discontinued anti-TNF due to severe induced skin lesions. Our objectives were to determine factors associated with dermatological remission [complete disappearance of skin lesions] and with IBD relapse in patients with inactive disease at inclusion, notably the impact of an early switch to another biological agent within 3 months of anti-TNF discontinuation. RESULTS: Among the 181 patients [134 women, 160 Crohn's disease] included in the 13 participating centres, dermatological remission occurred in 110 [62%] patients with a median [interquartile range, IQR] interval of 8.0 [6.8-11.0] months. Scalp location was independently associated with less remission of skin lesions (hazard ratio [HR] = 0.64 [95% CI 0.43-0.94], p = 0.02) while early switch was independently associated with a higher probability of remission of skin lesions (HR = 1.64 [95% CI 1.1-2.5], p = 0.02). Among the 148 patients with inactive IBD at inclusion, disease relapse occurred in 75 [51%] patients with a median [IQR] interval of 26.0 [23.0-39.1] months. Survival rates without IBD relapse at 1 year were 85.8% [95% CI 77.5-94.9] in the early switch group and 59.3% [95% CI 48.9-71.9] in the other group [p < 0.01]. CONCLUSIONS: Early switch to a new biological is associated with a higher probability of healing of anti-TNF-induced skin lesions and significantly reduces the risk of IBD relapse.
Disciplines :
Gastroenterology & hepatology
Author, co-author :
Cottron, C; CHU de Bordeaux, Hôpital Haut-Lévêque, Service d'Hépato-gastroentérologie et oncologie digestive - Université de Bordeaux, F-33000 Bordeaux, France.
Treton, X; Department of Gastroenterology, IBD and Nutrition, Beaujon Hospital, APHP, Paris, France.
Altwegg, R; Department of Hepatogastroenterology, Saint Eloi Hospital, CHU de Montpellier, Montpellier, France.
Reenaers, Catherine ; Centre Hospitalier Universitaire de Liège - CHU > > Service de gastroentérologie, hépatologie, onco. digestive
Amiot, A; Department of Gastroenterology, Henri Mondor Hospital, APHP, Creteil, France.
Fumery, M; Department of Gastroenterology, CHU de Amiens, and Peritox, UMR I-01, France.
Vuitton, L ; Department of Hepatogastroenterology, CHRU de Besançon, Besançon, France.
Peyrin-Biroulet, L; Department of Hepatogastroenterology, Nancy University Hospital, Vandoeuvre les Nancy, France.
Bouguen, G; CHU Rennes, Univ Rennes, INSERM, CIC1414, Institut NUMECAN (Nutrition Metabolism and Cancer), F-35000 Rennes, France.
Dewit, O; Department of Gastroenterology, Université Catholique de Louvain Saint Luc, Brussels, Belgium.
Nancey, S; Department of Gastroenterology, CHU de Lyon, Lyon Sud Hospital, University Claude Bernard Lyon 1, INSERM U1111, Lyon, France.
Caillo, L; Department of Hepatogastroenterology, CHU de Nîmes, Nîmes, France.
Roblin, X; Department of Hepatogastroenterology, CHU de Saint-Etienne, Hôpital Nord, Université Jean Monnet, Saint-Etienne, France.
Beylot-Barry, M; Department of Dermatology, Saint-André Hospital, CHU de Bordeaux, France.
Rivière, P ; CHU de Bordeaux, Hôpital Haut-Lévêque, Service d'Hépato-gastroentérologie et oncologie digestive - Université de Bordeaux, F-33000 Bordeaux, France.
Laharie, D; CHU de Bordeaux, Hôpital Haut-Lévêque, Service d'Hépato-gastroentérologie et oncologie digestive - Université de Bordeaux, F-33000 Bordeaux, France.
How to Manage Inflammatory Bowel Disease Patients When They Withdraw Anti-Tumour Necrosis Factor [Anti-TNF] Due to Severe Anti-TNF-Induced Skin Lesions? A Multicentre Cohort Study.
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