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

Publication

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

Journal Paper/Review - Apr 27, 2017

Vavricka Stephan R, Misselwitz Benjamin, Scharl Michael, Heinrich Henriette, Manser Christine N, Safroneeva Ekaterina, Raja Ali Raja Affendi, Rogler Gerhard, Schoepfer Alain M, Greuter Thomas, Zeitz Jonas, Biedermann Luc, Juillerat Pascal, Gubler Martin, Gantenbein Claudine, Spoerri Muriel, Froehlich Florian, Seibold Frank, Protic Marijana, Michetti Pierre, Straumann Alex, Fournier Nicolas

Citation

Vavricka S, Misselwitz B, Scharl M, Heinrich H, Manser C, Safroneeva E, Raja Ali R, Rogler G, Schoepfer A, Greuter T, Zeitz J, Biedermann L, Juillerat P, Gubler M, Gantenbein C, Spoerri M, Froehlich F, Seibold F, Protic M, Michetti P, Straumann A, Fournier N. Anti-TNF Treatment for Extraintestinal Manifestations of Inflammatory Bowel Disease in the Swiss IBD Cohort Study. Inflamm Bowel Dis 2017

Type

Journal Paper/Review (English)

Journal

Inflamm Bowel Dis 2017

Publication Date

Apr 27, 2017

Issn Electronic

1536-4844

Brief description/objective

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.