125746 20241125101128.0 doi 10.1093/ecco-jcc/jjad001 sideral 133275 ART-2023-133275 eng Noor, Nurulamin M ECCO topical review on biological treatment cycles in crohn’s disease 2023 Access copy available to the general public Unrestricted There are now a growing number of licensed biological therapies for patients with Crohn’s disease. However, there can be significant costs associated with long-term maintenance treatment, as well as some concerns about potential side-effects. As a result, there has been increasing interest in elective biological treatment discontinuation in selected patients, after a sustained period of remission. Following discontinuation, in cases of relapse, evidence to date has suggested that remission may often be regained by re-treatment with the same biological agent. Therefore, a concept has emerged in which cycles of biological therapy might be used. If this treatment strategy were to be applied in a subgroup of patients at low risk of relapse, cycling might allow a substantial number of patients to have a lower, overall therapeutic burden—ensuring decreased exposure to biological therapy but still enabling appropriate disease control.Currently, there remains uncertainty about the benefit–risk balance for using cycles of biological treatment for patients with Crohn’s disease. Accordingly, an expert panel was convened by the European Crohn’s and Colitis Organisation [ECCO] to review the published literature and agree a series of consensus practice points. The panel aimed to provide evidence-based guidance on multiple aspects of biological treatment discontinuation and cycling, including the risk of relapse after elective treatment discontinuation, predictors of probable relapse or remission, safety, patient preferences, and pharmacoeconomic aspects. Crucially, discussions about biological treatment discontinuation and cycling should be individualized, to enable shared decision-making by patients with their clinicians. info:eu-repo/grantAgreement/EC/H2020/633168/EU/BIOlogical therapy CYCLEs towards tailored, needs-driven, safer and cost-effective management of Crohn’s disease/BIOCYCLE This project has received funding from the European Union’s Horizon 2020 research and innovation program under grant agreement No H2020 633168-BIOCYCLE info:eu-repo/semantics/openAccess All rights reserved http://www.europeana.eu/rights/rr-f/ 8.3 2023 GASTROENTEROLOGY & HEPATOLOGY 14 / 143 = 0.098 2023 Q1 T1 2.705 2023 Medicine (miscellaneous) 2023 Q1 Gastroenterology 2023 Q1 15.5 2023 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion Sousa, Paula Bettenworth, Dominik Gomollón, Fernando Universidad de Zaragoza (orcid)0000-0003-0076-3529 Lobaton, Triana Bossuyt, Peter Casanova, Maria Jose Ding, Nik S Dragoni, Gabriele Furfaro, Federica van Rheenen, Patrick F Chaparro, Maria Gisbert, Javier P Louis, Edouard Papamichael, Konstantinos 1007 610 Universidad de Zaragoza Dpto. Medicina, Psiqu. y Derm. Area Medicina 17, 7 (2023), 1031–1045 J. Crohns Colitis Journal of Crohn's & colitis 1873-9946 493608 http://zaguan.unizar.es/record/125746/files/texto_completo.pdf Versión publicada 2806127 http://zaguan.unizar.es/record/125746/files/texto_completo.jpg?subformat=icon icon Versión publicada oai:zaguan.unizar.es:125746 articulos driver 2024-11-22-11:58:06 ARTICLE