Bethesda, MD (Feb. 3, 2014) — Children newly diagnosed with Crohn's disease may benefit from early treatment with the biologic drugs known as anti-TNF-α agents, according to a new study in Gastroenterology1, the official journal of the American Gastroenterological Association.
"While the use of biologic drugs, such as infliximab or adalimumab, is generally reserved for patients who have failed previous therapy for Crohn's disease, little is known about outcomes following the earlier use," said study author Jeffrey S. Hyams, MD, from Connecticut Children's Medical Center, Hartford. "This new research finds that, in children newly diagnosed with moderate to severe Crohn's disease, early anti-TNF-α therapy is more effective at achieving remission than the current standard treatment."
Using data from the RISK Stratification Study, an ongoing, prospective observational research program currently involving 28 pediatric gastroenterology centers in North America, researchers compared the effectiveness of early (within three months after diagnosis) treatment with anti-TNF-α inhibitors, compared with early treatment with immunomodulatory drugs, in attaining clinical remission and facilitating growth in children with Crohn's disease. The current standard of care is corticosteroids followed by the early introduction of immunomodulatory drugs.
At one-year, 85 percent of patients receiving early anti-TNF-α therapy alone were in corticosteroid-free clinical remission, a significantly greater proportion than those treated with either early immunomodulators alone (60 percent) or no early immunotherapy (54 percent). Further, at one-year, no patients in the early anti–TNF-α group had a Pediatric Crohn's Disease Activity Index of greater than 30, compared with 7 percent in the early immunomodulators group and 10 percent in the no early immunotherapy group. Only in the early anti-TNF- α group was normal growth velocity established.
Crohn's disease is a lifelong, relapsing disorder that can damage the bowel and lead to multiple abdominal operations over time. While there is no cure for Crohn's disease, medications can help control inflammation and relieve symptoms like abdominal pain, diarrhea and rectal bleeding. A patient's treatment will depend on location and severity of disease, complications and response to previous treatments. For more information on Crohn's disease, read AGA's patient brochure.
For more information on treating Crohn's disease, review the recently released AGA Institute guideline on the use of thiopurines, methotrexate and anti–TNF-α biologic drugs for the induction and maintenance of remission in inflammatory Crohn's disease.
Research funding for this study was provided by the Crohn's and Colitis Foundation of America.
1 Walters TD et al. Increased Effectiveness of Early Therapy With Anti–Tumor Necrosis Factor-α vs an Immunomodulator in Children With Crohn's Disease. Gastroenterology 2014; 146(2): 383-391.
About the AGA Institute
The American Gastroenterological Association is the trusted voice of the GI community. Founded in 1897, the AGA has grown to include 17,000 members from around the globe who are involved in all aspects of the science, practice and advancement of gastroenterology. The AGA Institute administers the practice, research and educational programs of the organization. http://www.gastro.org.
Gastroenterology, the official journal of the AGA Institute, is the most prominent scientific journal in the specialty and is in the top 1 percent of indexed medical journals internationally. The journal publishes clinical and basic science studies of all aspects of the digestive system, including the liver and pancreas, as well as nutrition. The journal is abstracted and indexed in Biological Abstracts, Current Awareness in Biological Sciences, Chemical Abstracts, Current Contents, Excerpta Medica, Index Medicus, Nutrition Abstracts and Science Citation Index. For more information, visit http://www.gastrojournal.org.
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