Practical guidance for the management of inflammatory bowel disease in patients with cancer. Which treatment?

Clinicians involved in the treatment of inflammatory bowel disease (IBD) increasingly come across patients with current or previous history of malignancies. With increasing and earlier use of immunosuppression and biologics in IBD patients, the question arises whether these treatments further increa...

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Main Authors: Shaji Sebastian, Steven Neilaj
Format: Article
Language:English
Published: SAGE Publishing 2019-01-01
Series:Therapeutic Advances in Gastroenterology
Online Access:https://doi.org/10.1177/1756284818817293
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spelling doaj-9c490681c6724885a5827b12b34c34652020-11-25T03:22:13ZengSAGE PublishingTherapeutic Advances in Gastroenterology1756-28482019-01-011210.1177/1756284818817293Practical guidance for the management of inflammatory bowel disease in patients with cancer. Which treatment?Shaji SebastianSteven NeilajClinicians involved in the treatment of inflammatory bowel disease (IBD) increasingly come across patients with current or previous history of malignancies. With increasing and earlier use of immunosuppression and biologics in IBD patients, the question arises whether these treatments further increase the risk of new or recurrent cancers. A number of population-based observational studies have now reported the odds of development of new or recurrent cancers with thiopurines and antitumour necrosis factors (anti-TNFs). These data combined with data arising from treatment registries from other immune disorders such as rheumatoid arthritis are providing evidence of relative risks and safety profiles of these agents in the setting of active or prior cancer. Data from transplant literature give an indication for providing a drug-holiday period in patients with treated cancers. The risks of the treatment should be considered alongside the risk associated with withholding these effective treatments in patients with active IBD. In this review, we aim to summarize the current evidence in this area and provide a practical guidance.https://doi.org/10.1177/1756284818817293
collection DOAJ
language English
format Article
sources DOAJ
author Shaji Sebastian
Steven Neilaj
spellingShingle Shaji Sebastian
Steven Neilaj
Practical guidance for the management of inflammatory bowel disease in patients with cancer. Which treatment?
Therapeutic Advances in Gastroenterology
author_facet Shaji Sebastian
Steven Neilaj
author_sort Shaji Sebastian
title Practical guidance for the management of inflammatory bowel disease in patients with cancer. Which treatment?
title_short Practical guidance for the management of inflammatory bowel disease in patients with cancer. Which treatment?
title_full Practical guidance for the management of inflammatory bowel disease in patients with cancer. Which treatment?
title_fullStr Practical guidance for the management of inflammatory bowel disease in patients with cancer. Which treatment?
title_full_unstemmed Practical guidance for the management of inflammatory bowel disease in patients with cancer. Which treatment?
title_sort practical guidance for the management of inflammatory bowel disease in patients with cancer. which treatment?
publisher SAGE Publishing
series Therapeutic Advances in Gastroenterology
issn 1756-2848
publishDate 2019-01-01
description Clinicians involved in the treatment of inflammatory bowel disease (IBD) increasingly come across patients with current or previous history of malignancies. With increasing and earlier use of immunosuppression and biologics in IBD patients, the question arises whether these treatments further increase the risk of new or recurrent cancers. A number of population-based observational studies have now reported the odds of development of new or recurrent cancers with thiopurines and antitumour necrosis factors (anti-TNFs). These data combined with data arising from treatment registries from other immune disorders such as rheumatoid arthritis are providing evidence of relative risks and safety profiles of these agents in the setting of active or prior cancer. Data from transplant literature give an indication for providing a drug-holiday period in patients with treated cancers. The risks of the treatment should be considered alongside the risk associated with withholding these effective treatments in patients with active IBD. In this review, we aim to summarize the current evidence in this area and provide a practical guidance.
url https://doi.org/10.1177/1756284818817293
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AT stevenneilaj practicalguidanceforthemanagementofinflammatoryboweldiseaseinpatientswithcancerwhichtreatment
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