Lower Risk of B1-to-pB3-Stage Migration in Crohn's Disease Upon Immunosuppressive and Anti-TNF Treatment in the Swiss IBD Cohort Study.
Details
Serval ID
serval:BIB_F3A4DE5531B1
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Lower Risk of B1-to-pB3-Stage Migration in Crohn's Disease Upon Immunosuppressive and Anti-TNF Treatment in the Swiss IBD Cohort Study.
Journal
Digestive diseases and sciences
Working group(s)
Swiss IBD Cohort Study Group
Contributor(s)
Anderegg C., Bauerfeind P., Beglinger C., Begré S., Belli D., Bengoa J.M., Biedermann L., Bigler B., Binek J., Blattmann M., Boehm S., Borovicka J., Braegger C.P., Brunner N., Bühr P., Burnand B., Burri E., Buyse S., Cremer M., Criblez D.H., de Saussure P., Degen L., Delarive J., Doerig C., Dora B., Dorta G., Egger M., Ehmann T., El-Wafa A., Engelmann M., Ezri J., Felley C., Fliegner M., Fournier N., Fraga M., Frei P., Frei R., Fried M., Froehlich F., Funk C., Furlano R.I., Gallot-Lavallée S., Geyer M., Girardin M., Golay D., Grandinetti T., Gysi B., Haack H., Haarer J., Helbling B., Hengstler P., Herzog D., Hess C., Heyland K., Hinterleitner T., Hiroz P., Hirschi C., Hruz P., Iwata R., Jost R., Juillerat P., Brondolo V.K., Knellwolf C., Knoblauch C., Köhler H., Koller R., Krieger-Grübel C., Kullak-Ublick G., Künzler P., Landolt M., Lange R., Lehmann F.S., Macpherson A., Maerten P., Maillard M.H., Manser C., Manz M., Marbet U., Marx G., Matter C., McLin V., Meier R., Mendanova M., Meyenberger C., Michetti P., Misselwitz B., Moradpour D., Morell B., Mosler P., Mottet C., Müller C., Müller P., Müllhaupt B., Münger-Beyeler C., Musso L., Nagy A., Neagu M., Nichita C., Niess J., Noël N., Nydegger A., Obialo N., Oneta C., Oropesa C., Peter U., Peternac D., Petit L.M., Piccoli-Gfeller F., Pilz J.B., Pittet V., Raschle N., Rentsch R., Restellini S., Richterich J.P., Rihs S., Ritz M.A., Roduit J., Rogler D., Rogler G., Rossel J.B., Sagmeister M., Saner G., Sauter B., Sawatzki M., Schäppi M., Scharl M., Schelling M., Schibli S., Schlauri H., Uebelhart S.S., Schnegg J.F., Schoepfer A., Seibold F., Seirafi M., Semadeni G.M., Semela D., Senning A., Sidler M., Sokollik C., Spalinger J., Spangenberger H., Stadler P., Steuerwald M., Straumann A., Straumann-Funk B., Sulz M., Thorens J., Tiedemann S., Tutuian R., Vavricka S., Viani F., Vögtlin J., Von Känel R., Vonlaufen A., Vouillamoz D., Vulliamy R., Wermuth J., Werner H., Wiesel P., Wiest R., Wylie T., Zeitz J., Zimmermann D.
ISSN
1573-2568 (Electronic)
ISSN-L
0163-2116
Publication state
Published
Issued date
09/2020
Peer-reviewed
Oui
Volume
65
Number
9
Pages
2654-2663
Language
english
Notes
Publication types: Journal Article ; Multicenter Study ; Observational Study ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Publication Status: ppublish
Abstract
While the long-term evolution of disease behavior in Crohn's disease has been well described in the pre-anti-TNF era, our knowledge thereon remains scarce after the introduction of anti-TNF.
Our investigation examined the long-term evolution of disease concerning Montreal classification's B-stages over time in patients enrolled into the Swiss IBD Cohort Study between 2006 and 2017.
We analyzed prospectively collected SIBDCS data using a Markov model and multivariate testing for effects of treatment and other confounders on B-stage migration over time. The primary outcome was a transition in disease behavior from B1 to either B2 or pB3, or from B2 to pB3, respectively.
The 10- and 15-year probability of remaining in B1 was 0.61 and 0.48, as opposed to a probability to migrate to B2 or B3 of 0.25 or 0.14, and 0.32 or 0.2, after 10 and 15 years, respectively. In multivariate testing, the hazard ratio for migrating from B1 to pB3 (HR 0.27) and from B2 to pB3 (HR 0.12) was lower in patients > 40 years compared to patients < 17 years. We found that immunosuppression (HR 0.38) and treatment with anti-TNF for > 1 year (HR 0.30) were associated with a decreased likelihood of transitioning from stage B1 to pB3.
While in the anti-TNF era most patients with Crohn's disease will eventually develop stricturing and/or penetrating complications, our data indicate that immunosuppressive and anti-TNF treatment for more than 1 year reduce the risk of transitioning from stage B1 to pB3 in the long-term run.
Our investigation examined the long-term evolution of disease concerning Montreal classification's B-stages over time in patients enrolled into the Swiss IBD Cohort Study between 2006 and 2017.
We analyzed prospectively collected SIBDCS data using a Markov model and multivariate testing for effects of treatment and other confounders on B-stage migration over time. The primary outcome was a transition in disease behavior from B1 to either B2 or pB3, or from B2 to pB3, respectively.
The 10- and 15-year probability of remaining in B1 was 0.61 and 0.48, as opposed to a probability to migrate to B2 or B3 of 0.25 or 0.14, and 0.32 or 0.2, after 10 and 15 years, respectively. In multivariate testing, the hazard ratio for migrating from B1 to pB3 (HR 0.27) and from B2 to pB3 (HR 0.12) was lower in patients > 40 years compared to patients < 17 years. We found that immunosuppression (HR 0.38) and treatment with anti-TNF for > 1 year (HR 0.30) were associated with a decreased likelihood of transitioning from stage B1 to pB3.
While in the anti-TNF era most patients with Crohn's disease will eventually develop stricturing and/or penetrating complications, our data indicate that immunosuppressive and anti-TNF treatment for more than 1 year reduce the risk of transitioning from stage B1 to pB3 in the long-term run.
Keywords
Adolescent, Adult, Aged, Aged, 80 and over, Crohn Disease/classification, Crohn Disease/diagnosis, Crohn Disease/drug therapy, Crohn Disease/immunology, Disease Progression, Female, Humans, Immunosuppressive Agents/therapeutic use, Male, Middle Aged, Prospective Studies, Risk Assessment, Risk Factors, Severity of Illness Index, Switzerland, Time Factors, Treatment Outcome, Tumor Necrosis Factor Inhibitors/therapeutic use, Young Adult, Crohn’s disease, Disease-modifying, Immunosuppressive agents, Montreal classification, Tumor necrosis factor-alpha
Pubmed
Web of science
Create date
04/01/2020 12:39
Last modification date
09/04/2024 7:14
Usage data
