Children newly diagnosed with Crohn's disease may benefit from early treatment with the biologic drugs known as anti-TNF-alpha agents, according to a new study in Gastroenterology, the official journal of the American Gastroenterological Association.
While the use of biologic drugs, such as Infliximab [ Remicade ] or Adalimumab [ Humira ], is generally reserved for patients who have failed previous therapy for Crohn's disease, little is known about outcomes following the earlier use.
This new research has found that, in children newly diagnosed with moderate to severe Crohn's disease, early anti-TNF-alpha 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-alpha 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% of patients receiving early anti-TNF-alpha therapy alone were in corticosteroid-free clinical remission, a significantly greater proportion than those treated with either early immunomodulators alone ( 60% ) or no early immunotherapy ( 54% ).
Further, at one-year, no patients in the early anti–TNF-alpha group had a Pediatric Crohn's Disease Activity Index of greater than 30, compared with 7% in the early immunomodulators group and 10% in the no early immunotherapy group. Only in the early anti-TNF-alpha group was normal growth velocity established. ( Xagena )
Source: American Gastroenterological Association ( AGA ), 2014