NOVEL Health Strategies and Abbvie's New Study Shows Value of Anti-TNFs for Early Crohn's Disease
NOVEL Health Strategies and Abbvie just published a new study showing value of Anti-TNFs for early Crohn's disease. The full text of the publication can be accessed at APT journal's website https://onlinelibrary.wiley.com/doi/epdf/10.1111/apt.15685
There is an increasing body of evidence showing that earlier use of biologics improves clinical outcomes in Crohn's disease (CD).
To perform a systematic review and meta-analysis to assess the impact of early biologic use in the treatment of CD.
PubMed and Embase databases were searched for English language papers and conference abstracts published through April 30, 2019. Studies were selected for inclusion if patients initiated biologics within 2 years of a CD diagnosis or if earlier biologics use (top-down) was compared with a conventional step-up strategy. Random-effects meta-analyses were conducted to compare clinical remission (CR), relapse and endoscopic healing rates between early biologic treatment (<2 years of disease duration or top-down treatment strategy) and late/conventional treatment (biologic use after >2 years of disease duration or conventional step-up treatment strategy).
A total of 3069 records were identified, of which 47 references met the selection criteria for systematic review. A total of 18 471 patients were studied, with a median follow-up of 64 weeks (range 10-416). Meta-analysis found that early use of biologics was associated with higher rates of clinical remission (OR 2.10 [95% CI: 1.69-2.60], n = 2763, P < .00001), lower relapse rates (OR 0.31 [95% CI: 0.14-0.68], n = 596, P = .003) and higher mucosal healing rates (OR 2.37 [95% CI: 1.78-3.16], n = 994, P < .00001) compared with late/conventional management.
Early biologic treatment is associated with improved clinical outcomes in both adult and paediatric CD patients, not only in prospective clinical trials but also in real-world settings.