The immunomodulators mercaptopurine and azathioprine decrease corticosteroid dependence and maintain remission in Crohn's disease.
Dr Jaya Punati and colleagues from Ohio, USA describe immunomodulator use in newly diagnosed pediatric Crohn's disease, comparing outcomes of early versus late initiation of therapy.
The team obtained data from pediatric Crohn's disease patients enrolled in a prospective, multicenter observational study.
|80% with newly diagnosed Crohn's were treated with immunomodulators within 1 year|
|Inflammatory Bowel Diseases|
Moderate/severe disease patients treated with immunomodulator were compared based on timing of initiation of immunomodulator therapy.
The team compared outcomes of remission, corticosteroid use, infliximab therapy, hospitalizations, and Crohn's disease-related surgery.
The researchers reported that 247 children met the criteria, and 199 used an immunomodulator within 1 year of diagnosis.
The team noted that 150 patients used an immunomodulator early between 0 to 3 months, and 49 started therapy late between 3 to 12 months.
The team found both groups showed a decrease in corticosteroid use by 12 months.
The research team observed that 22% of early group patients had received corticosteroids in the preceding quarter vs 41% in late groups patients.
The number of hospitalizations per patient was also noted to be significantly lower in the early group over the 2-year follow-up.
No difference was noted in the rates of remission, infliximab use over time, or surgery.
Dr Punati's team concluded, "80% of children with newly diagnosed moderate to severe Crohn's disease are treated with immunomodulator within 1 year."
"Early immunomodulator use is associated with reduced corticosteroid exposure and possibly fewer hospitalizations per patient."