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CC BY 4.0 · Journal of Coloproctology 2024; 44(02): e126-e130
DOI: 10.1055/s-0044-1787285
Original Article

Evaluation of Crohn's Disease Recurrence after Suspension of Immunobiological use in Patients in Sustained Remission

Ana Carolina Lisboa
1   Federal University of Sergipe, São Cristóvão, SE, Brazil
,
Victor Mayer Duarte Santos
1   Federal University of Sergipe, São Cristóvão, SE, Brazil
,
Júlia Naves de Almeida 
1   Federal University of Sergipe, São Cristóvão, SE, Brazil
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Abstract

Objective To evaluate the relapse rate after discontinuation of biological therapy in patients with Crohn's disease treated at the University Hospital.

Methods This is a series of 9 cases of CD patients who used long-term immunobiologicals. Non-randomized sample, followed for 1 year, prospectively.

Results Nine patients were studied, 8 females, with an average age of 43.8 years, and non-smokers. The average time of use of the immunobiological for suspension was 6.77 years, with 66.66% of them having been in use for more than 5 years. The mean initial CDAI was 25. After 6 months of follow-up, CRP was less than 10 mg/L in 88.8% of them. Only 3 patients measured the Calprotectin, low. (10, 15 and 30 mcg/g). The ESR averaged 15.77 mm/h. In 66.6% of those studied, the 6-month colonoscopy was normal - mayo 0. In the 1-year follow-up, 3 patients underwent CT, normal. At 1-year colonoscopy of 3 patients, there was endoscopic recurrence in 2. The mean CDAI after the first year was 38.11. The mean ESR was 17.11 mm/h. The worst outcomes occurred in 2 (20%) patients, both Montreal A3L3B2, with clinical and endoscopic recurrence. The same previous immunobiological was reintroduced, with excellent clinical response.

Conclusion Individualized analysis of the course of the disease proves to be the best way for adequate clinical monitoring during its use, optimization of the therapeutic regimen, and the possibility of interruption.

Keywords

Crohn's disease - immunobiological - recurrence

Sources of Research Grants

Authors' own resources.


Research Ethics Committee Approval

Project number: CAAE-16480819.9.0000.5546.


Opinion Number: 3.701.757


Institution: Human Research Ethics Committee of the Federal University of Sergipe.




Publication History

Received: 09 October 2023

Accepted: 09 April 2024

Article published online:
06 June 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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