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.

TitleEarly 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.
Publication TypeJournal Article
Year of Publication2019
AuthorsFrei, R, Fournier, N, Zeitz, J, Scharl, M, Morell, B, Greuter, T, Schreiner, P, Misselwitz, B, Safroneeva, E, Schoepfer, AM, Vavricka, SR, Rogler, G, Biedermann, L
Corporate AuthorsGroup, SIBDCohort
JournalJournal of Crohn's & colitis
Date Published03/2019
DOI10.1093/ecco-jcc/jjz057
ISSN1876-4479
Keywordsanti-TNF, early intervention, long-term outcome
Abstract

BACKGROUND AND AIMS: The optimal timing of treatment escalation in Crohn's disease (CD) remains a challenge 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).

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.

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 to 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 to patients who were treated late or never (3.6% versus 8.8% versus 3.7%, p=0.016).

CONCLUSIONS: Early anti-TNF administration was found to be associated with several indicators of a more favourable long-term outcome, in CD patients within the SIBDCS.

Alternate URL

https://www.ncbi.nlm.nih.gov/pubmed/30854548?dopt=Abstract

Alternate JournalJ Crohns Colitis
Citation Key / SERVAL ID9577
Peer reviewRefereed
PubMed ID30854548

                         

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