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How to manage inflammatory bowel disease patients when they withdraw anti-TNF due to severe anti-TNF-induced skin lesions? A multicenter cohort study

Abstract : BACKGROUND and AIMS: Optimal management of patients with inflammatory bowel disease (IBD) after anti-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 multicenter retrospective study including consecutive IBD patients who discontinued anti-TNF due to severe induced skin lesions. 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 three months of anti-TNF discontinuation. RESULTS: Among the 181 patients (134 women, 160 Crohn’s disease) included in the 13 participating centers, dermatological remission occurred in 110 (62%) patients with a median (interquartile range) 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 higher probability of healing of anti-TNF-induced skin lesions and significantly reduces risk of IBD relapse.
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https://hal.archives-ouvertes.fr/hal-03594480
Contributor : Laurent Jonchère Connect in order to contact the contributor
Submitted on : Wednesday, March 2, 2022 - 4:24:38 PM
Last modification on : Wednesday, March 30, 2022 - 2:43:10 PM

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C Cottron, X Treton, R Altwegg, C Reenaers, A Amiot, et al.. How to manage inflammatory bowel disease patients when they withdraw anti-TNF due to severe anti-TNF-induced skin lesions? A multicenter cohort study. Journal of Crohn's and Colitis, Elsevier - Oxford University Press, 2022, ⟨10.1093/ecco-jcc/jjac035⟩. ⟨hal-03594480⟩

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