Please use this identifier to cite or link to this item:
https://repository.monashhealth.org/monashhealthjspui/handle/1/35621
Title: | Immunomodulator use does not prevent first loss of response to anti-tumour necrosis factor alpha therapy in inflammatory bowel disease: long-term outcomes in a real-world cohort. | Authors: | Crantock L.R.F.;Sorrell C.;Rusli F.;Dev A. ;Moore G.T.;Pianko S. ;Ratnam D.T.;Varma P.;Rajadurai A.S.;Holt D.Q.;Devonshire D.A.;Desmond C.P.;Swan M.P. ;Nathan D.;Shelton E.T.;Prideaux L. | Institution: | (Varma, Rajadurai, Holt, Devonshire, Desmond, Swan, Nathan, Shelton, Prideaux, Sorrell, Rusli, Crantock, Dev, Ratnam, Pianko, Moore) Department of Gastroenterology and Hepatology, Monash Medical Centre, Melbourne, VIC, Australia (Holt, Moore) School of Clinical Sciences, Monash University, Melbourne, VIC, Australia | Issue Date: | 21-Jun-2019 | Copyright year: | 2019 | Publisher: | Blackwell Publishing | Place of publication: | Australia | Publication information: | Internal Medicine Journal. 49 (6) (pp 753-760), 2019. Date of Publication: June 2019. | Journal: | Internal Medicine Journal | Abstract: | Background: Recent prospective studies suggest combination therapy with immunomodulators improves efficacy, but long-term data is limited. Aim(s): To assess whether anti-tumour necrosis factor alpha (anti-TNF) monotherapy was associated with earlier loss of response (LOR) than combination therapy in a real-world cohort with long-term follow up. Method(s): A retrospective audit was conducted of inflammatory bowel disease patients receiving anti-TNF therapy in a tertiary centre and specialist private practices. All patients with accurate data for anti-TNF commencement and adequate correspondence to determine end-points were included. Outcomes measured included time to first LOR, causes and biochemical parameters. Result(s): Two hundred and twenty-four patients were identified; 139 (62.1%) on combination therapy and 85 (37.9%) on monotherapy. Forty-five percent of patients had LOR during follow up until a maximum of 8.5 years; 59.4% on combination therapy and 40.6% on monotherapy (P = 0.533). The median time to LOR was not different between groups; 1069 days for combination therapy and 1489 days for monotherapy (P = 0.533). There was no difference in time to LOR between patients treated with different combination regimens or different anti-TNF agents. Conclusion(s): In this large cohort of patients in a real-world setting, patients treated with anti-TNF monotherapy had similar rates of LOR as patients on anti-TNF combination therapy, at both short- and long-term follow up.Copyright © 2018 Royal Australasian College of Physicians | DOI: | http://monash.idm.oclc.org/login?url=http://dx.doi.org/10.1111/imj.14150 | PubMed URL: | 30381884 [http://www.ncbi.nlm.nih.gov/pubmed/?term=30381884] | ISSN: | 1444-0903 | URI: | https://repository.monashhealth.org/monashhealthjspui/handle/1/35621 | Type: | Article | Subjects: | drug withdrawal female follow up human infection/si [Side Effect] *inflammatory bowel disease/dt [Drug Therapy] long term care major clinical study male medical specialist melanoma/si [Side Effect] monotherapy mycoplasmosis/si [Side Effect] osteomyelitis/si [Side Effect] outcome assessment perianal abscess/si [Side Effect] pertussis/si [Side Effect] priority journal private practice recurrent infection/si [Side Effect] retina disease/si [Side Effect] retrospective study Clostridium infection/si [Side Effect] combination drug therapy controlled study drug hypersensitivity/si [Side Effect] *tumor necrosis factor inhibitor/ae [Adverse Drug Reaction] *tumor necrosis factor inhibitor/cm [Drug Comparison] *tumor necrosis factor inhibitor/dt [Drug Therapy] adolescent adult alopecia areata/si [Side Effect] article bacterial infection/si [Side Effect] clinical audit cohort analysis tertiary care center treatment duration treatment outcome *treatment response *immunomodulating agent/ae [Adverse Drug Reaction] *immunomodulating agent/cm [Drug Comparison] *immunomodulating agent/dt [Drug Therapy] drug hypersensitivity / side effect adolescent adult alopecia areata / side effect Article bacterial infection / side effect clinical audit Clostridium infection / side effect cohort analysis combination drug therapy controlled study drug withdrawal female follow up human infection / side effect *inflammatory bowel disease / *drug therapy long term care major clinical study male medical specialist melanoma / side effect monotherapy mycoplasmosis / side effect osteomyelitis / side effect outcome assessment perianal abscess / side effect pertussis / side effect priority journal private practice recurrent infection / side effect retina disease / side effect retrospective study tertiary care center treatment duration treatment outcome *treatment response |
Type of Clinical Study or Trial: | Observational study (cohort, case-control, cross sectional or survey) |
Appears in Collections: | Articles |
Show full item record
Items in Monash Health Research Repository are protected by copyright, with all rights reserved, unless otherwise indicated.