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Aliment Pharmacol Ther. 2011 Apr;33(8):870-9. doi: 10.1111/j.1365-2036.2011.04599.x. Epub 2011 Feb 15.

Review article: remission rates achievable by current therapies for inflammatory bowel disease.

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1
INSERM U954 and Department of Hepato-Gastroenterology, University Hospital of Nancy, Henri Poincaré University, Vandœuvre-lès-Nancy, France.

Abstract

BACKGROUND:

New medical therapies have improved outlook in inflammatory bowel disease but published impact on surgical rates has been modest suggesting that many patients are still not attaining remission.

AIM:

To review remission rates with current medical treatments for inflammatory bowel disease.

METHODS:

We searched MEDLINE (source PUBMED, 1966 to January, 2011).

RESULTS:

Induction and maintenance of remission was observed in 20% (range, 9-29.5%) and 53% (range, 36.8-59.6%) of ulcerative colitis (UC) patients treated with oral 5-ASA derivatives. Induction of remission was noted in 52% (range, 48-58%) of Crohn's disease (CD) patients and 54% of UC patients treated with steroids in population-based cohorts. Maintenance of remission was reported in 71% (range, 56-95%) of CD patients on azathioprine over a 6-month to 2-year period and in 60% (range, 41.7-82.4%) in UC at 1 year or longer. Induction and maintenance of remission was noted in 39% (range, 19.3-66.7%) and 70% (range, 39-90%) of CD patients on methotrexate over a 40-week period. Induction of remission was reported in 32% (range, 25-48%), 26% (range, 18-36%) and 20% (range, 19-23%) of CD patients on infliximab, adalimumab or certolizumab pegol, respectively. The corresponding figures were 45% (range, 39-59%), 43% (range, 40-47%) and 47.9% at weeks 20-30 among initial responders. Induction of remission was observed in 33% (range, 27.5-38.8%) and 18.5% of UC patients on infliximab or adalimumab, respectively. Maintenance of remission was noted in 33% (range, 25.6-36.9%) of UC patients on infliximab at week 30. Approximately one-fifth of CD and UC patients treated with biologicals require intestinal resection after 2-5 years in referral-centre studies.

CONCLUSION:

In the era of biologics, the proportion of patients with inflammatory bowel disease not entering remission remains high.

[Indexed for MEDLINE]
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