Publications by authors named "Jonas Louwers"
Background: The intestinal microbiota plays a significant role in maintaining systemic and intestinal homeostasis, but can also influence diseases such as inflammatory bowel disease (IBD) and cancer. Certain bacterial species within the intestinal tract can chronically activate the immune system, leading to low-grade intestinal inflammation. As a result, plasma cells produce high levels of secretory antigen-specific immunoglobulin A (IgA), which coats the immunostimulatory bacteria.
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- A study investigated the effects of stopping immunomodulators like thiopurines or methotrexate in patients with inflammatory bowel disease (IBD) who were on anti-TNF therapies, comparing outcomes of withdrawal versus continuation of treatment.
- The research included 614 treatment episodes from 543 patients, revealing that withdrawing immunomodulators did not increase the risk of losing response to treatment, although it did lead to a higher frequency of anti-drug antibodies.
- Key findings highlighted that being in clinical remission at the time of withdrawal lowered the risk of losing treatment response, while higher drug levels before stopping the immunomodulators reduced the chances of developing anti-drug antibodies.
Article Synopsis
- Inflammatory bowel disease (IBD) treatment with anti-TNFα shows a significant loss of response in the first year (17.2% annually) compared to after four years (4.8% annually), indicating that long-term treatment may improve patient stability.
- A study of 844 treatment episodes found that the overall incidence of anti-TNFα discontinuation and dose escalations also decreased significantly from the first year to after four years.
- Factors influencing loss of response included having ulcerative colitis (UC) over Crohn's disease (CD), specific disease types in CD, and gender, while using immunomodulators appeared to reduce the risk of developing anti-drug antibodies.