scholarly journals The effect of early immunosuppressive therapy on the rate of resections performed in patients with Chron’s disease, in Veszprém county, Hungary, a population-based cohort study

2012 ◽  
Vol 153 (14) ◽  
pp. 541-552 ◽  
Author(s):  
Petra Anna Golovics ◽  
Péter László Lakatos ◽  
Gyula Dávid ◽  
Tünde Pandur ◽  
Zsuzsanna Erdélyi ◽  
...  

Medical therapy for Crohn’s disease has changed significantly over the past 20 years with the increasing use of immunosuppressants. In contrast, surgery rates are still high and evidence about the the changes in the outcome of Crohn’s disease over the past decades is scarce. Aims: The objective of this study was to analyze the evolution of the surgical rates and medical therapy in the population-based Veszprém county database. Methods: Data of 506 Crohn’s disease patients were analyzed (age at diagnosis: 31.5 years, SD: 13.8 years). Both hospital and outpatient records were collected and comprehensively reviewed. The study population was divided into three groups based on the year of diagnosis (cohort A: 1977–1989, cohort B: 1990–1998 and cohort C: 1999–2008). Results: Overall azathioprine, systemic steroid, and biological (only available after 1998) exposure was 45.8, 68.6, and 9.5%, respectively. The 1 and 5-year probabilities of azathioprine use were 3.2 and 6.2% in cohort A, 11.4 and 29.9% in cohort B, and 34.8 and 46.2% in cohort C. In multivariate analysis, decade of diagnosis (P<0.001), age at onset (P = 0.008), disease behavior at diagnosis (P<0.001), and need for systemic steroids (P<0.001) were significantly associated with the time to initiation of azathioprine therapy. Early azathioprine use was significantly associated with the time to intestinal surgery in Crohn’s disease patients; in a multivariate Cox analysis (HR: 0.43, 95% confidence interval (CI): 0.28–0.65) and after matching on propensity scores for azathioprine use (HR: 0.42,95% CI:0.26–0.67). Conclusions: This population-based inception cohort showed that reduction in surgical rates was independently associated with increased and earlier azathioprine use. Orv. Hetil., 2012, 153, 541–552.

2001 ◽  
Vol 120 (5) ◽  
pp. A628-A628
Author(s):  
E LOFTUSJR ◽  
C CROWSON ◽  
W SANDBORN ◽  
W TREAMINE ◽  
W OFALLON ◽  
...  

2021 ◽  
Author(s):  
Burton I Korelitz ◽  
Judy Schneider

Abstract We present a bird’s eye view of the prognosis for both ulcerative colitis and Crohn’s disease as contained in the database of an Inflammatory Bowel Disease gastroenterologist covering the period from 1950 until the present utilizing the variables of medical therapy, surgical intervention, complications and deaths by decades.


2010 ◽  
Vol 2 ◽  
pp. CMT.S2840
Author(s):  
Arkady Broder ◽  
Joel R. Rosh

The past decade has brought great change to the treatment of pediatric Crohn's disease. The majority of affected patients now receive therapy directed at the underlying immune dysregulation that is associated with this chronic disease. The monoclonal antibodies directed against tumor necrosis factor alpha play an increasing role in such therapy. Infliximab is the prototype of this class of biologic based therapy. This review covers the basic pharmacokinetics of infliximab while reviewing the data on its efficacy in pediatric Crohn's disease patients. Current issues related to infliximab dosing and safety are also reviewed.


2019 ◽  
Vol 156 (6) ◽  
pp. S-1422
Author(s):  
Paul T. Kroner ◽  
Alex M. Kesler ◽  
Peter Abader ◽  
Mohammad Afsh ◽  
Victor Ciofoaia ◽  
...  

2015 ◽  
Vol 148 (4) ◽  
pp. S-22-S-23 ◽  
Author(s):  
Steven Jeuring ◽  
Tim Van den Heuvel ◽  
Maurice Zeegers ◽  
Wim Hameeteman ◽  
Mariëlle Romberg-Camps ◽  
...  

Sign in / Sign up

Export Citation Format

Share Document