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P466 Relapse rates of inflammatory bowel disease patients in deep and clinical remission after discontinuing anti-tumour necrosis factor alpha therapy: a prospective single-centre open-label study

T. Hlavaty*, A. Krajcovicova, J. Letkovsky, I. Sturdik, T. Koller, J. Toth, M. Huorka

Comenius University, Faculty of Medicine and University Hospital Bratislava, Fifth Department of Internal Medicine, Bratislava, Slovakia

Background

Relapse rates after discontinuing anti-tumour necrosis factorα (TNFα) therapy of inflammatory bowel disease (IBD) patients in deep remission are poorly understood. This prospective single-centre open-label study evaluated the relapse rates of IBD patients after stopping anti-TNFα therapy.

Methods

All IBD patients who were in clinical remission and stopped anti-TNFα therapy in 2011–2013 and were followed-up for at least 12 months were enrolled. The ‘Ultradeep’ patients were in calprotectin-negative (< 50 ug/g) deep remission for at least 6 months and ceased anti-TNFα therapy on physician recommendations. The ‘Clinical’ patients were in clinical but not deep remission and ceased anti-TNFα therapy for other reasons. Relapse rates were assessed and relapse risk factors identified.

Results

One year after stopping, 27% and 27% of the Ultradeep (n = 11) and Clinical (n = 11) patients relapsed, respectively. Two years after stopping, 57% and 62% relapsed, respectively (p = 0.89). All relapsed patients who underwent retreatment with anti-TNFα therapy re-entered remission. Male sex was a significant risk factor for relapse (p = 0.03).

Conclusion

Regardless of their calprotectin and deep-remission status at baseline, 27% and 60% of all IBD patients relapsed within 1 and 2 years after ceasing anti-TNFα therapy, respectively. Male sex was the only risk factor for clinical relapse.