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Early Initiation of Anti-TNF is Associated with Favourable Long-term Outcome in Crohn's Disease: 10-Year-Follow-up Data from the Swiss IBD Cohort Study.
- Source :
-
Journal of Crohn's & colitis [J Crohns Colitis] 2019 Sep 27; Vol. 13 (10), pp. 1292-1301. - Publication Year :
- 2019
-
Abstract
- Background and Aims: The optimal timing of treatment escalation in Crohn's disease [CD] remains a challenging issue, and very little is known about its long-term development following early versus late administration of anti-TNF antibodies. The long-term outcome of Swiss CD patients was comparatively assessed in an up to 10-year follow-up, using patients participating in the Swiss Inflammatory Bowel Disease Cohort Study [SIBDCS].<br />Methods: Prospectively collected SIBDCS patient data, including disease history, baseline characteristics at enrolment, and course of disease, were analysed in patients with early versus late [<24 versus ≥24 months after diagnosis] and no anti-TNF treatment.<br />Results: A reduced risk of developing bowel stenosis was found in patients who received early anti-TNF treatment. This association was seen in patients overall and also in the subgroups of CD patients without pre-existing complications [Log-rank test: p < 0.001].Furthermore, osteoporosis and anaemia were observed significantly less frequently in patients who received early anti-TNF treatment, compared with either patients who received treatment late [p < 0.001 and p = 0.046, respectively] or were never [p < 0.001 for both] treated with anti-TNF antibodies. Patients with early anti-TNF administration sought medical consultations significantly less often, including gastroenterologists in private practice [p = 0.017], ambulatory [outpatient] hospital visits [p = 0.038], and a composite of any medical visits [p = 0.001]. The percentage of patients unable to work was lowest for early-anti-TNF-treated patients, in comparison with patients who were treated late or never [3.6% vs 8.8% vs 3.7%, p = 0.016].<br />Conclusions: In CD patients within the SIBDCS, early anti-TNF administration was found to be associated with several indicators of a more favourable long-term outcome.<br /> (Copyright © 2019 European Crohn’s and Colitis Organisation (ECCO). Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.)
- Subjects :
- Adult
Anti-Inflammatory Agents administration & dosage
Anti-Inflammatory Agents adverse effects
Crohn Disease complications
Female
Follow-Up Studies
Humans
Intestinal Obstruction epidemiology
Intestinal Obstruction etiology
Intestinal Obstruction prevention & control
Male
Middle Aged
Prospective Studies
Switzerland
Time Factors
Treatment Outcome
Anti-Inflammatory Agents therapeutic use
Crohn Disease drug therapy
Tumor Necrosis Factor-alpha antagonists & inhibitors
Subjects
Details
- Language :
- English
- ISSN :
- 1876-4479
- Volume :
- 13
- Issue :
- 10
- Database :
- MEDLINE
- Journal :
- Journal of Crohn's & colitis
- Publication Type :
- Academic Journal
- Accession number :
- 30854548
- Full Text :
- https://doi.org/10.1093/ecco-jcc/jjz057