Help
Subscribe


All of GastroHep is now free access! - Click here to register Read For FREE - Our full range of review articles
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy Profile of Guido Tytgat Profile of Pete Peterson Profile of Peter Cotton Profile of Roy Pounder

Home

News  
Journals
Review Articles
Slide Atlas
Video Clips
Online Books
Advanced Digestive Endoscopy
Classical Cases
Conference Diary
PubMed
International GH Links
USA GH Links
National GH Links
National GI Societies
Other Useful Links




Emails on Gastroenterology and Hepatology
the National AIDS Treatment Advocacy Project
Visit the gastroenterology section of the EUMS

News

Response to biologic therapy in Crohn's disease is improved with early treatment

A recent study in the Inflammatory Bowel Diseases examines the response to biologic therapy in Crohn's disease.

News image

Anti-tumor necrosis factor therapy is an important treatment option for management of active Crohn's disease and is labeled for use after failure of conventional therapy. 

However, there is debate on the introduction of anti-TNF agents earlier in the treatment strategy to potentially improve clinical outcomes. 
 
Dr David Rubin from the USA determined if a top-down approach with anti-TNF therapy is associated with improved outcomes for patients with active Crohn's disease.

Claims data were from adult patients with Crohn's disease with continuous enrollment in the same health plan for ≥6 months prior to the initial diagnostic claim for Crohn's disease, 12 months after their initial anti-TNF claim, and with anti-TNF claims after their initial diagnosis for Crohn's disease.
 
The research team identified 3 patient groups.
A top-down approach to anti-TNF therapy was associated with a lower risk of corticosteroid use
Inflammatory Bowel Diseases
 
The Step-Up group used 5-aminosalicylates and/or corticosteroids prior to anti-TNF.
 
Secondly, the immunosuppression (IS)-to-TNF inhibitor group used IS prior to anti-TNF therapy.
 
Finally, the Early-TNF group initiated anti-TNF therapy within 30 days of the first prescription for Crohn's disease.
 
Response to anti-TNF therapy was determined up to 24 months following anti-TNF initiation by concomitant corticosteroid use, Crohn's disease surgery, anti-TNF dose escalation, and anti-TNF discontinuation/switch. 

The doctors reported that a top-down approach to anti-TNF therapy was associated with a lower risk of concomitant corticosteroid use, anti-TNF dose escalation, discontinuation/switch of anti-TNF, and Crohn's disease-related surgery compared with the step-up and IS-to-TNF therapy approaches.

Dr Rubin's team concludes,  "These 'real-world' data show that a top-down approach to anti-TNF therapy in Crohn's disease is associated with reductions in loss of response and fewer surgeries than conventional step-wise management."

Inflamm Bowel Dis 2012: 18(12): 22252231

05 December 2012

Go to top of page Email this page Email this page to a colleague

 24 May 2015

Advanced search
 22 May 2015 
Colonoscopy screening for colorectal cancer
 22 May 2015 
Treatment with anti-integrin antibodies in IBD
 22 May 2015 
Care of patients with GERD
 21 May 2015 
Lymphoma in IBD
 21 May 2015 
Serrated polyps and colorectal cancer
 21 May 2015 
Imaging for hepatocellular carcinoma
 20 May 2015 
Surveillance in long-segment Barrett's
 20 May 2015 
Pancreatic neuroendocrine tumors
 20 May 2015 
Refractory metastatic colorectal cancer
 19 May 2015 
Metabolic syndrome and Barrett's
 19 May 2015 
PPIs and cryptogenic liver abscess
 19 May 2015 
Anti-integrin antibodies in IBD
 18 May 2015 
ESPGHAN celiac guidelines
 18 May 2015 
HLA haplotypes and primary sclerosing cholangitis
 18 May 2015 
Safety of PPI
 15 May 2015 
Microscopic colitis risk with PPIs/NSAIDs
 15 May 2015 
Management of nonhospitalized ulcerative colitis
 15 May 2015 
Diabetes and infections in IBD with immunomodulation
 14 May 2015 
Diagnosis of spontaneous bacterial peritonitis
 14 May 2015 
Mortality in US patients with cirrhosis
 14 May 2015 
Radiation exposure during ERCP
 13 May 2015 
Predictors of IBD
 13 May 2015 
Psychological distress and liver disease mortality
 13 May 2015 
Hypnotherapy in IBS/IBD
 12 May 2015 
Bleeding in NSAID users with H.pylori
 12 May 2015 
Capsule colonoscopy detects colorectal polyps
 12 May 2015 
Anti-TNF biologics in acute severe ulcerative colitis
 11 May 2015 
Management of Barrett's esophagus
 11 May 2015 
Marker to detect recurrence of Crohn's
 11 May 2015 
Thalidomide for IBD
 08 May 2015 
Surveillance colonoscopy in colorectal cancer
 08 May 2015 
HCV treatment with compensated cirrhosis
 08 May 2015 
Medical management of Crohn's
 07 May 2015 
Surgical complications in ulcerative colitis
 07 May 2015 
Combination therapy for noncirrhostic patients
 07 May 2015 
Anxiety and new-onset dyspepsia
 06 May 2015 
PPIs and spontaneous bacterial peritonitis
 06 May 2015 
Infant feeding and celiac disease
 06 May 2015 
Preventing recurrent C. diff infection
 05 May 2015 
Fatigue in primary sclerosing cholangitis
 05 May 2015 
Annual CT scans after esophagectomy for cancer
 05 May 2015 
Prevalence of eosinophilic esophagitis
 04 May 2015 
Stress resilience and peptic ulcer disease
 04 May 2015 
Endoscope storage and microbial colonization
 04 May 2015 
Menarche and NAFLD
 01 May 2015 
Sleep and physical activity measured in Crohn's
 01 May 2015 
NAFLD progression from steatosis to fibrosing-steatohepatitis
 01 May 2015 
Dietary supplement hepatotoxicity
 30 April 2015 
Risk factors for primary sclerosing cholangitis
 30 April 2015 
Botulinum toxin A for the treatment of obesity
 30 April 2015 
Neoadjuvant chemoradiotherapy for esophageal cancer
 29 April 2015 
Liver enzyme elevations after anti-TNF therapy in IBD

 29 April 2015 
Hepatocellular carcinoma surveillance in HBV
 29 April 2015 
Response to sorafenib in hepatocellular carcinoma
 28 April 2015 
Risk factors of hepatocellular carcinoma
 28 April 2015 
Clinical outcomes after esophagectomy
 28 April 2015 
Alcohol drinking and risk of liver cirrhosis
 23 April 2015 
Gut microbiota modulation for alcoholic liver disease
 23 April 2015 
Moderate sodium restriction diet in cirrhosis
 23 April 2015 
Gastroesophageal junction disruption and obesity

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2015 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us