Help
Subscribe


GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy

 29 June 2016

Advanced search
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy 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): 2225–2231

05 December 2012

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

 29 June 2016 
Progression to esophageal carcinoma in Barrett's
 29 June 2016 
Hep C eradication in people who inject drugs
 29 June 2016 
Anti-tumor necrosis factor in mothers and newborns
 28 June 2016 
Gastric cancer screening in the USA
 28 June 2016 
Acute severe ulcerative colitis
 28 June 2016 
Cancer recurrence after immune-suppressive therapies
 27 June 2016 
Epidemiology of NAFLD
 27 June 2016 
Tobacco smoking and ulcerative colitis
 27 June 2016 
The Toronto Consensus for H. pylori treatment
 24 June 2016 
Dietary trends in the USA
 24 June 2016 
Statins and colorectal cancer in IBD
 24 June 2016 
Fibre for chronic idiopathic constipation
 23 June 2016 
Biomarker for eosinophilic esophagitis diagnosis
 23 June 2016 
Touch screens in the IBD outpatient clinic
 23 June 2016 
Adverse events after colonoscopy bowel preparations
 22 June 2016 
Benefits and harms of colorectal cancer screening
 22 June 2016 
IBS symptoms in IBD
 22 June 2016 
Outcomes among US veterans with Hep B
 21 June 2016 
Screening for colorectal cancer
 21 June 2016 
Tenofovir and Hep B transmission in mothers
 21 June 2016 
Access to liver subspecialty care and survival
 20 June 2016 
Genes for colorectal cancer risk
 20 June 2016 
Patients and gastroenterologists’ perceptions on IBD
 20 June 2016 
Hep C treatment in people who inject drugs
 17 June 2016 
Noninvasive markers of liver fibrosis
 17 June 2016 
Predictors of starting with long-term PPIs
 17 June 2016 
Extrahepatic manifestations of Hep C
 16 June 2016 
Assessing progression of NAFLD
 16 June 2016 
Endotracheal intubation and endoscopy unit efficiency metrics
 16 June 2016 
Bile acid diarrhea
 15 June 2016 
Consensus for acute severe ulcerative colitis
 15 June 2016 
Dental erosions in GERD
 15 June 2016 
Pharmacological treatments for obesity with weight loss
 14 June 2016 
Antibiotics and gut inflammation
 14 June 2016 
Liver-related mortality in the developed world
 14 June 2016 
Hep C patient outcomes treated with different anti-viral regimens
 13 June 2016 
Obesity in the USA
 13 June 2016 
Celiac disease drug development
 13 June 2016 
Pneumonia risk in celiac disease
 10 June 2016 

Celiac disease drug development

 10 June 2016 
Rectal cancer surgery checklist
 10 June 2016 
Breath as a marker for IBS
 09 June 2016 
Psychological morbidity in young people with IBD
 09 June 2016 
Evaluation of endoscopic findings from patients with Crohn's
 09 June 2016 
Predicting hepatic encephalopathy in cirrhosis
 08 June 2016 
Adult obesity trends in the USA
 08 June 2016 
Pediatric IBD unclassified vs other IBD
 08 June 2016 
Dark chocolate and NASH oxidation
 07 June 2016 
Flexible endoscopy for Zenker's diverticulum
 07 June 2016 
Predicting risk of hepatic encephalopathy in cirrhosis
 07 June 2016 
Electronic learning system for colon capsule endoscopy
 06 June 2016 
Oral contraceptives and Crohn’s complications
 06 June 2016 
Disturbed sleep and symptoms in IBS
 06 June 2016 
Eosinophilic esophagitis
 03 June 2016 
Antibiotic prophylaxis in cirrhosis
 03 June 2016 
Mortality in hospitalized peptic ulcer patients
 03 June 2016 
Decision aid for surgical patients with ulcerative colitis
 02 June 2016 
Allergy tests for eosinophilic esophagitis
 02 June 2016 
Fatty liver disease and mortality
 02 June 2016 
Ethnic inequalities in rectal cancer care

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2016 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us