Osamura A, et al. - The researchers performed a retrospective study of treatment outcomes and clinical factors using clinical data over a 14-year period to identify the factors affecting the efficacy of long-term Crohn’s disease (CD) treatment with tumor necrosis factor (TNF) inhibitors. In CD patients, the durability of anti-TNF therapy remained a problem. Treatment optimization that included dose escalation needed to be carefully examined depending on patient characteristics and the timing of optimization.

Methods

• The researchers examined clinical characteristics and factors for surgery, hospitalization, and TNF inhibitor treatment discontinuation in 219 biologic-naïve patients who were treated with TNF inhibitors at their hospital before October 2014.

Results

• For 1, 5, and 10 years, treatment persistence rates with no hospitalization, surgery, or dose escalation were 60.7, 25.9, and 17.3%, respectively.
• These rates did not differ between infliximab (IFX) and adalimumab.
• One- and 5-year persistence rates were approximately 90.4 and 65.1%, respectively in patients receiving IFX dose escalation.
• The researchers identified previous surgery (OR = 1.45, P=0.043) as a risk factor for surgery, male sex (OR = 0.70, P=0.044) and previous surgery (OR = 1.51, P=0.03) were risk factors for hospitalization, and perianal fistula (OR = 1.39, P=0.049) was the risk factor for TNF inhibitor treatment discontinuation.