remission rates for IBD drugs

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my little penguin

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Summary
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.


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

L. Peyrin-Biroulet1, M. Lémann2,†
Article first published online: 15 FEB 2011

DOI: 10.1111/j.1365-2036.2011.04599.x





from:

http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2036.2011.04599.x/full
 
Thanks for posting mlp.

In many ways it doesn’t surprise me that the biologics don’t offer greater hope and I don’t think that will change while ever IBD remains the poor cousin to other autoimmune diseases. Those with IBD receive these drugs as a flow on effect purely because of the common denominator of being autoimmune rather than tackling the core issue that is IBD. :(
 
:voodoo::voodoo::voodoo:

But call me polyanna...I just read the whole report and it doesn't sound as depressing as I originally thought.

Of interest was the loss of response to Remicade at 5mg/kg and the fact that increasing to 10mg/kg increases response and then also the shortening of interval between infusions increases the response.
 
Thanks for posting! I am disheartened. :( As a new user of Humira, I was hoping for higher remission rates. I sure hope I'm not going through all of this biologic treatment for nothing...
 
Yep the whole report is better ....
Also keep in mind these are adult numbers which may or may not translate to kiddie numbers.

My kiddo never read any other Ibd memo ( hence dx at age 7)
So I am planning on him not reading this on either .
 
"Overall, there would seem no logical reason to choose enteral nutrition over steroids for the vast majority of adult CD patients."

Yeah! Good thing O never read this part either! But then again she is a ped patient!
 

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