Withdrawal of immunosuppressant or biologic therapy for patients with quiescent Crohn's disease

The Cochrane Database of Systematic Reviews
Ray K BoyapatiJean-Frédéric Colombel

Abstract

Crohn's disease (CD) is a chronic, relapsing and remitting disease of the gastrointestinal tract that can cause significant morbidity and disability. Current treatment guidelines recommend early intervention with immunosuppressant or biological therapy in high-risk patients with a severe disease phenotype at presentation. The feasibility of therapeutic de-escalation once remission is achieved is a commonly encountered question in clinical practice, driven by patient and clinician concerns regarding safety, adverse events, cost and national regulations. Withdrawal of immunosuppressant and biologic drugs in patients with quiescent CD may limit adverse events and reduce healthcare costs. Alternatively, stopping these drug therapies may result in negative outcomes such as disease relapse, drug desensitization, bowel damage and need for surgery. To assess the feasibility and safety of discontinuing immunosuppressant or biologic drugs, administered alone or in combination, in patients with quiescent CD. We searched CENTRAL, MEDLINE, Embase and the Cochrane IBD Group Specialized Register from inception to 19 December 2017. We also searched the reference lists of potentially relevant manuscripts and conference proceedings to identify a...Continue Reading

References

Oct 6, 1997·BMJ : British Medical Journal·M EggerC Minder
Jan 23, 1999·European Journal of Gastroenterology & Hepatology·N P ThompsonA J Wakefield
Nov 24, 1999·The American Journal of Gastroenterology·P S KimG W Gleim
Sep 6, 2003·BMJ : British Medical Journal·Julian P T HigginsDouglas G Altman
Jun 9, 2005·Gastroenterology·Marc LémannUNKNOWN Groupe D'Etude Thérapeutique des Affections Inflammatoires du Tube Digestif
Jul 26, 2006·The American Journal of Gastroenterology·Charles N BernsteinJames F Blanchard
Oct 3, 2006·Inflammatory Bowel Diseases·Richard B GearryMurray L Barclay
Apr 1, 2008·Journal of Pediatric Gastroenterology and Nutrition·Jan WynandsFrank M Ruemmele
Oct 14, 2008·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Xavier TretonUNKNOWN Groupe D'Etude Thérapeutique Des Affections Inflammatoires Du Tube Digestif (GETAID)
Jun 30, 2009·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Corey A SiegelBruce E Sands
Feb 6, 2010·Nature Reviews. Gastroenterology & Hepatology·Geert R D'Haens
Apr 16, 2010·The New England Journal of Medicine·Jean Frédéric ColombelUNKNOWN SONIC Study Group
Jun 29, 2011·Gastroenterology·Laurent Peyrin-BirouletUNKNOWN Cesame Study Group
Sep 29, 2011·Gastroenterology·Edouard LouisUNKNOWN Groupe D'etudes Thérapeutiques Des Affections Inflammatoires Digestives
Feb 9, 2012·Alimentary Pharmacology & Therapeutics·A BuissonL Peyrin-Biroulet
May 16, 2012·Gastroenterology·Millie D LongMichael D Kappelman
Sep 5, 2012·The American Journal of Gastroenterology·Laurent Peyrin-BirouletEdward V Loftus
Oct 30, 2012·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Zuzana ZelinkovaUNKNOWN Dutch Delta IBD Group
Nov 9, 2012·Gut·Mirthe Emilie van der ValkUNKNOWN COIN study group and the Dutch Initiative on Crohn and Colitis
Nov 28, 2012·Alimentary Pharmacology & Therapeutics·T MolnárT Wittmann
Mar 26, 2013·Journal of Crohn's & Colitis·Vincent BillioudLaurent Peyrin-Biroulet
Jun 5, 2014·Digestive and Liver Disease : Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver·Armelle ChauvinAurelien Amiot
Jun 19, 2014·JAMA : the Journal of the American Medical Association·Nynne Nyboe AndersenTine Jess
Jun 25, 2014·Alimentary Pharmacology & Therapeutics·B Pariente, D Laharie
Jan 8, 2015·Journal of Pediatric Gastroenterology and Nutrition·Jarosław KierkuśMałgorzata Sładek
Jan 30, 2015·Alimentary Pharmacology & Therapeutics·J M BenítezJ P Gisbert
Apr 26, 2015·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Victoria GrossiJeffrey S Hyams
Sep 4, 2015·Scandinavian Journal of Gastroenterology·Martin BortlikMilan Lukas

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Citations

Jul 3, 2018·Current Gastroenterology Reports·Catarina Frias GomesJoana Torres
Feb 13, 2020·F1000Research·Simon P Borg-BartoloRahul Kalla

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