Patient-Specific Approach to Combination Versus Monotherapy with the Use of Antitumor Necrosis Factor ⍺ Agents for Inflammatory Bowel Disease - 12/04/12

Doi : 10.1016/j.gtc.2012.01.012

Shane M. Devlin, MD, FRCPC ^a,^⁎ , Adam S. Cheifetz, MD ^b, Corey A. Siegel, MD, MS ^c
BRIDGe group
^a Division of Gastroenterology and Hepatology, The University of Calgary, 3280 Hospital Drive NW, Calgary, Alberta T2N4N1, Canada
^b Center for Inflammatory Bowel Disease, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
^c Dartmouth Medical School and The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth-Hitchock Medical Center, Lebanon, NH, USA

Corresponding author

Keywords : Antitumor necrosis factor ⍺, Thiopurines, Methotrexate, Crohn disease, Inflammatory bowel disease, Infliximab, Adalimumab, Certolizumab-pegol, Infection, Lymphoma

Plan

The History of the Combination Therapy Versus Monotherapy Debate (How Did We Get Here Anyway?)

What are the Infectious Risks Associated With Combination Therapy?

Is There an Increased Risk of NHL With Combination Therapy, and How Should We Approach the Risk of HSTCL?

What is the Benefit of Combination Therapy?

What Does Combination Therapy Mean: AZA? MTX? Either?

One Size Does Not Fit All: A Systematic Approach to Develop an Algorithm for When to Use Combination Therapy

Can We Withdraw the Anti-TNF⍺ Agent When a Patient on Combination Therapy is Doing Well?

What are the Questions We Need Answered?

Summary

The BRIDGe (Building Research in IBD Globally) group is comprised of Leonard Baidoo, University of Pittsburgh, Pittsburgh, Pennsylvania; Brian Bressler, University of British Columbia, Vancouver, British Columbia, Canada; Adam S Cheifetz, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts; Shane M. Devlin, The University of Calgary, Calgary, Alberta, Canada; Laura E. Raffals, Mayo Clinic, Rochester, Minnesota; Peter M. Irving, Guy's and St. Thomas' Hospitals London, United Kingdom; Jennifer Jones, University of Saskatchewan, Saskatoon, Saskatchewan, Canada; Gilaad G. Kaplan, The University of Calgary, Calgary, Alberta, Canada; Patricia L. Kozuch, Jefferson University, Philadelphia, Pennsylvania; Gil Y. Melmed, Cedars-Sinai Medical Center, Los Angeles, California; Corey A. Siegel, Dartmouth-Hitchock Medical Center, Lebanon, New Hampshire; Miles P. Sparrow, Department of Gastroenterology, The Alfred Hospital, Melbourne, Australia; Fernando S. Velayos, University of California San Francisco, San Francisco, California.