Anti-TNF Treatment for Extraintestinal Manifestations of Inflammatory Bowel Disease in the Swiss IBD Cohort Study.

Vavricka, Stephan R; Gubler, Martin; Gantenbein, Claudine; Spoerri, Muriel; Froehlich, Florian; Seibold, Frank; Protic, Marijana; Michetti, Pierre; Straumann, Alex; Fournier, Nicolas; Juillerat, Pascal; Biedermann, Luc; Zeitz, Jonas; Misselwitz, Benjamin; Scharl, Michael; Heinrich, Henriette; Manser, Christine N; Safroneeva, Ekaterina; Raja Ali, Raja Affendi; Rogler, Gerhard; ... (2017). Anti-TNF Treatment for Extraintestinal Manifestations of Inflammatory Bowel Disease in the Swiss IBD Cohort Study. Inflammatory bowel diseases, 23(7), pp. 1174-1181. Lippincott Williams & Wilkins 10.1097/MIB.0000000000001109

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BACKGROUND Extraintestinal manifestations (EIMs) in patients with inflammatory bowel disease (IBD) are frequently observed. Little is known about the efficacy of anti-tumor necrosis factor (TNF) in EIM management. We assessed the effect of 3 anti-TNF agents (infliximab, adalimumab, and certolizumab pegol) on EIM evolution. METHODS Data on 1249 patients from the Swiss IBD Cohort Study (SIBDCS) were analyzed. All EIMs were diagnosed by relevant specialists. Response was classified into improvement, stable disease, and clinical worsening based on the physician's interpretation. RESULTS Of the 366 patients with at least 1 EIM, 213 (58.2%) were ever treated with an anti-TNF. A total of 299 treatments were started for 355 EIMs. Patients with EIM were significantly more often treated with anti-TNF compared with those without EIM (58.2% versus 21.0%, P < 0.001). Infliximab was the most frequently used drug (63.2%). In more than 71.8%, a clinical response of the underlying EIM to anti-TNF therapy was observed. In 92 patients (43.2%), anti-TNF treatments were started for the purpose of treating EIM rather than IBD. Response rates to anti-TNF were generally good and best for psoriasis, aphthous stomatitis, uveitis, and peripheral arthritis. In 11 patients, 14 EIM occurred under anti-TNF treatment. CONCLUSIONS Anti-TNF was frequently used among patients with EIM. In more than 40%, anti-TNF treatments are started to treat EIM rather than IBD. Given the good response rates, anti-TNF seems to be a valuable option in the treatment of EIM, whereas appearance of EIM under anti-TNF does not seem to be a source of considerable concern.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine > Gastroenterology
04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine

UniBE Contributor:

Seibold, Frank Werner; Juillerat, Pascal and Safroneeva, Ekaterina

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

1078-0998

Publisher:

Lippincott Williams & Wilkins

Language:

English

Submitter:

Tanya Karrer

Date Deposited:

05 Sep 2017 13:34

Last Modified:

01 Aug 2018 02:30

Publisher DOI:

10.1097/MIB.0000000000001109

PubMed ID:

28452862

BORIS DOI:

10.7892/boris.102379

URI:

https://boris.unibe.ch/id/eprint/102379

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