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Spacing the Administration Interval of Anti-TNF Agents: A Valid Strategy for Patients with Inflammatory Bowel Disease?

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Abstract

Background

Increasing the interval of administration of anti-TNF agents over the duration specified in the data sheet is not common in inflammatory bowel disease (IBD).

Aim

To evaluate the outcomes of IBD patients treated with this strategy.

Methods

Patients with IBD who were treated with infliximab or adalimumab at intervals > 8 weeks or > 2 weeks, respectively, because of persistent clinical remission, were identified at local databases of the ENEIDA registry (a nationwide registry promoted by the Spanish Working Group in Crohn’s disease and Ulcerative Colitis-GETECCU) of two referral centers. Treatment success was considered if patients remained in clinical remission with the same schedule or without biological therapy at the end of follow-up, and if no return to the conventional schedule, dose-escalation, change in biological agent, or a course of systemic corticosteroids or surgery were required.

Results

Eighty-five patients were included, 60 treated with infliximab and 25 with adalimumab. The spaced schedule was initiated after a median of 25 months on anti-TNF treatment (IQR 14–49). Throughout a median follow-up of 34 months (IQR 21–47), fifty patients (59%) fulfilled the success criteria of the spaced strategy. No differences were found regarding type of IBD or anti-TNF agent. Baseline C-reactive protein levels and disease duration at the time of starting anti-TNF treatment were the only factors associated with treatment success.

Conclusions

Anti-TNF administration at longer intervals than those provided in the data sheet may be an efficacious, convenient, and cheaper treatment option, particularly in patients in whom anti-TNF treatment was initiated early.

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Acknowledgments

PT received a research grant from the Fundació Catalunya La Pedrera.

Funding

No funding was received specifically for this study.

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Authors and Affiliations

  1. Gastroenterology Department, Hospital Universitari Germans Trias i Pujol, Badalona, Spain

    Paola Torres, Fiorella Cañete, Ariadna Aguilar, Margalida Calafat, Míriam Mañosa & Eugeni Domènech

  2. Institut d’Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Spain

    Paola Torres

  3. Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain

    Fiorella Cañete, Míriam Mañosa & Eugeni Domènech

  4. Gastroenterology and Hepatology Department, Hospital Ramón y Cajal, Madrid, Spain

    Laura Núñez, Francisco Mesonero, Cristina Fernández & Antonio López-Sanromán

  5. Immunology Department, Hospital Universitari Germans Trias i Pujol, Badalona, Spain

    Aïna Teniente

Authors
  1. Paola Torres
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  2. Fiorella Cañete
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Corresponding author

Correspondence to Eugeni Domènech.

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Conflicts of interest

Laura Núñez has received educational grants from Janssen; Míriam Mañosa has served as a speaker and has received research or educational funding from MSD, AbbVie, Takeda, Janssen, Ferring, and Pfizer; Francisco Mesonero has served as a speaker for Janssen, MSD, Takeda y Abbvie; Fiorella Cañete has served as a speaker or has received educational grants from Takeda, Janssen, MSD, and Ferring; Margalida Calafat has served as a speaker for Takeda, Janssen, Faes Farma and MSD; Antonio López-Sanromán has served as a speaker, a consultant and an advisory member for or has received research funding from MSD, Abbvie, Pfizer, Takeda, Janssen, Ferring, Faes Farma, Shire Pharmaceuticals, Dr. Falk Pharma, Tillotts Pharma, Chiesi, Gebro Pharma, and Vifor Pharma; Eugeni Domènech has served as a speaker or has received research or educational funding or advisory fees from MSD, AbbVie, Takeda, Kern Pharma, Pfizer, Janssen, Celgene, Adacyte Therapeutics, Otsuka Pharmaceuticals, Ferring, Shire Pharmaceuticals, Tillots Pharma, Thermofisher, Grifols, and Gebro. The remaining authors declared no conflicts of interest.

Informed consent

This is a retrospective study based on the local databases of the ENEIDA registry (a nationwide registry of IBD patients promoted by the Spanish Working Group in Crohn’s disease and Ulcerative Colitis-GETECCU). The registry was approved by the Ethics Committees at both centers, and all patients gave their informed consent.

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Torres, P., Cañete, F., Núñez, L. et al. Spacing the Administration Interval of Anti-TNF Agents: A Valid Strategy for Patients with Inflammatory Bowel Disease?. Dig Dis Sci 65, 2036–2043 (2020). https://doi.org/10.1007/s10620-019-06010-w

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  • DOI: https://doi.org/10.1007/s10620-019-06010-w

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