The Relapse Rate of Inflammatory Bowel Disease (IBD) in Patients Who Discontinue Anti-TNF Therapy: A Systematic Review and Meta-Analysis.

IF 1.3 4区医学 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Iranian Journal of Public Health Pub Date : 2024-09-01 DOI:10.18502/ijph.v53i9.16452

Fatemeh Ebrahimi, Samaneh Torkian, Elahe Zare-Farashbandi, Babak Tamizifar

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Abstract

Background: Inflammatory bowel disease (IBD) patients who cease anti-tumor necrosis factor (TNF) therapy are at risk of relapse, which is a matter of concern for the medical community. This study aimed to determine the relapse rate of IBD in patients who cease anti- TNF therapy.

Methods: A systematic search of international databases (Medline, Web of Sciences, Scopus, and EMBASE) was conducted until Mar 9th, 2022. The random effects model was used to calculate the IBD relapse rate, accompanied by a 95% confidence interval.

Results: The IBD relapse rate in patients who discontinued anti-TNF therapy was 44%. The pooled IBD-UC and IBD-CD relapse rate in patients who stopped anti-TNF therapy were 43% and 46%, respectively. The studies using infliximab (IFX) showed a pooled IBD relapse rate of 45%, and the IBD relapse rate in the IFX/ADA (Adalimumab) group was 42%. The IBD relapse rate for papers with treatment durations of less than or equal to 12 months was 51%, while for articles with treatment durations of more than 12 months, it was 30%.

Conclusion: This study emphasizes the need for careful evaluation and monitoring of IBD patients who cease anti-TNF therapy, as well as further investigation of alternative treatments for those who exhibit intolerance or inadequate response to anti-TNF therapy.

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停用抗肿瘤坏死因子疗法的炎症性肠病 (IBD) 患者的复发率：系统回顾与元分析》。

背景：停止抗肿瘤坏死因子（TNF）治疗的炎症性肠病（IBD）患者有复发的风险，这是医学界关注的问题。本研究旨在确定停止抗肿瘤坏死因子治疗的 IBD 患者的复发率：方法：对截至 2022 年 3 月 9 日的国际数据库（Medline、Web of Sciences、Scopus 和 EMBASE）进行了系统检索。采用随机效应模型计算IBD复发率，并得出95%的置信区间：结果：停止抗肿瘤坏死因子治疗的患者中，IBD复发率为44%。停止抗肿瘤坏死因子治疗的患者中，IBD-UC和IBD-CD的复发率分别为43%和46%。使用英夫利昔单抗（IFX）的研究显示，汇总的IBD复发率为45%，IFX/ADA（阿达木单抗）组的IBD复发率为42%。治疗时间少于或等于12个月的文章的IBD复发率为51%，而治疗时间超过12个月的文章的IBD复发率为30%：本研究强调了对停止抗肿瘤坏死因子治疗的 IBD 患者进行仔细评估和监测的必要性，以及进一步研究对抗肿瘤坏死因子治疗不耐受或反应不充分的患者的替代治疗方法的必要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Iranian Journal of Public Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-

CiteScore

2.20

自引率

7.10%

发文量

300

审稿时长

3-8 weeks

期刊介绍： Iranian Journal of Public Health has been continuously published since 1971, as the only Journal in all health domains, with wide distribution (including WHO in Geneva and Cairo) in two languages (English and Persian). From 2001 issue, the Journal is published only in English language. During the last 41 years more than 2000 scientific research papers, results of health activities, surveys and services, have been published in this Journal. To meet the increasing demand of respected researchers, as of January 2012, the Journal is published monthly. I wish this will assist to promote the level of global knowledge. The main topics that the Journal would welcome are: Bioethics, Disaster and Health, Entomology, Epidemiology, Health and Environment, Health Economics, Health Services, Immunology, Medical Genetics, Mental Health, Microbiology, Nutrition and Food Safety, Occupational Health, Oral Health. We would be very delighted to receive your Original papers, Review Articles, Short communications, Case reports and Scientific Letters to the Editor on the above mentioned research areas.