SPARE trial - Crohn's disease

 RCT looking at withdrawal of infliximab or immunomodulator, in patients on combination therapy and in remission for atleast 6 months

- 211 patients randomized in 7 countries (Australia / Nordic countries, UK, France) to either continuing both, stopping infliximab or stopping immunomodulator 

- Patients with fistulising disease, or severe reaction to infliximab were excluded.



Risk of relapse at 2 years:

Combination therapy: 14%

Ifx stopped = 36%

immunomodulator stopped = 10%


Nearly all patients who relapsed on Ifx withdrawal were promptly re-captured by starting Ifx


Stopping Ifx in patients with CD on combination therapy results in an excess 21% increase in risk of relapse. 

No increase risk of relapse in stopping immunomodulator after stable remission has been achieved.

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