Impact of the early use of immunomodulators or TNF antagonists on bowel damage and surgery in Crohn's disease.
Details
Serval ID
serval:BIB_AD2BAFA8BBA3
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Impact of the early use of immunomodulators or TNF antagonists on bowel damage and surgery in Crohn's disease.
Journal
Alimentary Pharmacology and Therapeutics
Working group(s)
Swiss IBD Cohort Study Group
Contributor(s)
Bauerfeind P., Beglinger C., Begré S., Bengoa J., Binek J., Boller D., Borovicka J., Braegger C., Burnand B., Camara R., Criblez D., de Saussure P., Degen L., Delarive J., Ehmann T., Engelmann M., Wafa AE., Felley C., Frei A., Frei R., Fried M., Friedt M., Froehlich F., Gallot-Lavallée S., Gerlach T., Geyer M., Girardin M., Goetze O., Haack H., Hediger S., Hengstler P., Heyland K., Janiak P., Juillerat P., Brondolo VK., Knoblauch C., Kullak-Ublick GA., Maillard M., Manz M., Marbet U., Meier R., Meyenberger C., Michetti P., Mottet C., Müller C., Müllhaupt B., Nicolet T., Nydegger A., Pache I., Piccoli F., Pilz J., Rentsch R., Rey JP., Rihs S., Rogler D., Sagmeister M., Sauter B., Schaub N., Schibli S., Seibold F., Spalinger J., Stadler P., Steuerwald M., Sul M., Tempia-Caliera M., Thorens J., Vader JP., Vögtlin J., Von Känel R., Wachter G., Wermuth J., Wiesel P.
ISSN
1365-2036 (Electronic)
ISSN-L
0269-2813
Publication state
Published
Issued date
2015
Volume
42
Number
8
Pages
977-989
Language
english
Abstract
BACKGROUND: The impact of early treatment with immunomodulators (IM) and/or TNF antagonists on bowel damage in Crohn's disease (CD) patients is unknown.
AIM: To assess whether 'early treatment' with IM and/or TNF antagonists, defined as treatment within a 2-year period from the date of CD diagnosis, was associated with development of lesser number of disease complications when compared to 'late treatment', which was defined as treatment initiation after >2 years from the time of CD diagnosis.
METHODS: Data from the Swiss IBD Cohort Study were analysed. The following outcomes were assessed using Cox proportional hazard modelling: bowel strictures, perianal fistulas, internal fistulas, intestinal surgery, perianal surgery and any of the aforementioned complications.
RESULTS: The 'early treatment' group of 292 CD patients was compared to the 'late treatment' group of 248 CD patients. We found that 'early treatment' with IM or TNF antagonists alone was associated with reduced risk of bowel strictures [hazard ratio (HR) 0.496, P = 0.004 for IM; HR 0.276, P = 0.018 for TNF antagonists]. Furthermore, 'early treatment' with IM was associated with reduced risk of undergoing intestinal surgery (HR 0.322, P = 0.005), and perianal surgery (HR 0.361, P = 0.042), as well as developing any complication (HR 0.567, P = 0.006).
CONCLUSIONS: Treatment with immunomodulators or TNF antagonists within the first 2 years of CD diagnosis was associated with reduced risk of developing bowel strictures, when compared to initiating these drugs >2 years after diagnosis. Furthermore, early immunomodulators treatment was associated with reduced risk of intestinal surgery, perianal surgery and any complication.
AIM: To assess whether 'early treatment' with IM and/or TNF antagonists, defined as treatment within a 2-year period from the date of CD diagnosis, was associated with development of lesser number of disease complications when compared to 'late treatment', which was defined as treatment initiation after >2 years from the time of CD diagnosis.
METHODS: Data from the Swiss IBD Cohort Study were analysed. The following outcomes were assessed using Cox proportional hazard modelling: bowel strictures, perianal fistulas, internal fistulas, intestinal surgery, perianal surgery and any of the aforementioned complications.
RESULTS: The 'early treatment' group of 292 CD patients was compared to the 'late treatment' group of 248 CD patients. We found that 'early treatment' with IM or TNF antagonists alone was associated with reduced risk of bowel strictures [hazard ratio (HR) 0.496, P = 0.004 for IM; HR 0.276, P = 0.018 for TNF antagonists]. Furthermore, 'early treatment' with IM was associated with reduced risk of undergoing intestinal surgery (HR 0.322, P = 0.005), and perianal surgery (HR 0.361, P = 0.042), as well as developing any complication (HR 0.567, P = 0.006).
CONCLUSIONS: Treatment with immunomodulators or TNF antagonists within the first 2 years of CD diagnosis was associated with reduced risk of developing bowel strictures, when compared to initiating these drugs >2 years after diagnosis. Furthermore, early immunomodulators treatment was associated with reduced risk of intestinal surgery, perianal surgery and any complication.
Pubmed
Web of science
Open Access
Yes
Create date
11/09/2015 9:44
Last modification date
20/08/2019 16:17
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