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01.12.2014 | Research article | Ausgabe 1/2014 Open Access

BMC Gastroenterology 1/2014

Efficacy of early immunomodulator therapy on the outcomes of Crohn’s disease

Zeitschrift:
BMC Gastroenterology > Ausgabe 1/2014
Autoren:
Min Seob Kwak, Duk Hwan Kim, Soo Jung Park, Tae Il Kim, Sung Pil Hong, Won Ho Kim, Jae Hee Cheon
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​1471-230X-14-85) contains supplementary material, which is available to authorized users.

Competing interests

No potential conflict of interest relevant to this article was reported.

Authors’ contributions

MSK and JHC contributed to the conception and design of the study. DHK, SJP, TIK, SPH, and WHK were responsible for acquisition, analysis and interpretation of data. MSK and JHC drafted the manuscript. All authors read and approved the final manuscript.

Abstract

Background

The natural course of Crohn’s disease (CD), with continuing relapses and remissions, leads to irreversible intestinal damage. Early adoption of immunomodulator therapy has been proposed in order to address this; however, it is still uncertain whether early immunomodulator therapy could affect the natural course of the disease in real practice. We evaluated the efficacy of such therapy on the prognosis of newly diagnosed patients with CD.

Methods

This retrospective study included 168 patients who were newly diagnosed with CD and who started treatment at Severance Hospital, Seoul, Korea between January 2006 and March 2013. The short- and long-term outcomes were compared between patients treated with early immunomodulator therapy and those treated with conventional therapy.

Results

A Kaplan-Meier analysis identified that administration of immunomodulators within 6 months after diagnosis of CD was superior to conventional therapy in terms of clinical remission and corticosteroid-free remission rates (P=0.043 and P=0.035). However, P=0.827). Patients with a baseline elevated CRP level were more likely to relapse (P<0.005). Drug-related adverse events were more frequent in the early immunomodulator therapy group than in the conventional therapy group P=0.029).

Conclusions

Early immunomodulator therapy was more effective than conventional therapy in inducing remission, but not in preventing relapse. Baseline high CRP level was a significant indicator of relapse.
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