dc.contributor.author | Klomberg, RCW | |
dc.contributor.author | van der Wal, HC | |
dc.contributor.author | Aardoom, MA | |
dc.contributor.author | Kemos, P | |
dc.contributor.author | Rizopoulos, D | |
dc.contributor.author | Ruemmele, FM | |
dc.contributor.author | Charrout, M | |
dc.contributor.author | Escher, HC | |
dc.contributor.author | Croft, NM | |
dc.contributor.author | de Ridder, L | |
dc.contributor.author | PIBD-SETQuality collaborative group | |
dc.date.accessioned | 2024-07-31T11:04:47Z | |
dc.date.available | 2024-07-31T11:04:47Z | |
dc.date.issued | 2023-11-27 | |
dc.identifier.citation | Renz C W Klomberg, Hella C van der Wal, Martine A Aardoom, Polychronis Kemos, Dimitris Rizopoulos, Frank M Ruemmele, Mohammed Charrout, Hankje C Escher, Nicholas M Croft, Lissy de Ridder, PIBD-SETQuality collaborative group , Improved Clinical Outcomes With Early Anti-Tumour Necrosis Factor Alpha Therapy in Children With Newly Diagnosed Crohn’s Disease: Real-world Data from the International Prospective PIBD-SETQuality Inception Cohort Study, Journal of Crohn's and Colitis, Volume 18, Issue 5, May 2024, Pages 738–750, https://doi.org/10.1093/ecco-jcc/jjad197 | en_US |
dc.identifier.uri | https://qmro.qmul.ac.uk/xmlui/handle/123456789/98492 | |
dc.description.abstract | BACKGROUND AND AIMS: Treatment guidelines for paediatric Crohn's disease [CD] suggest early use of anti-tumour necrosis factor alpha [anti-TNFα] in high-risk individuals. The aim is to evaluate the effect of early anti-TNF in a real-world cohort. METHODS: Children with newly diagnosed CD were prospectively recruited at 28 participating sites of the international observational PIBD-SETQuality study. Outcomes were compared at 3 months, 1 and 2 years between patients receiving early anti-TNF [<90 days after diagnosis] and those not receiving early anti-TNF. Outcomes included sustained steroid-free remission [SSFR] without treatment intensification [specified as SSFR*] and sustained steroid-free mild/inactive disease without treatment intensification [specified as SSFMI*]. Penalised logistic regression model-based standardisation was applied to estimate the relative risks [RR] of early therapy on outcomes. RRs were estimated for high-risk and low-risk patients, based on presence of predictors of poor outcome [POPOs] and disease activity at diagnosis. RESULTS: In total, 331 children (median age 13.9 years [IQR 12.2-15.3]) were enrolled, with 135 [41%] receiving early anti-TNF. At 1 year, patients on early anti-TNF had higher rates of SSFR* [30% vs 14%, p <0.001] and SSFMI* [69% vs 33%, p <0.001], with RRs of 2.95 [95% CI 1.63-5.36] and 4.67 [95% CI 2.46-8.87], respectively. At 1 year, the RRs for SSFMI* were higher, and statistically significant in high-risk patients, i.e. those with moderate/severe disease compared with mild/inactive disease at diagnosis (5.50 [95% CI 2.51-12.05] vs 2.91 [95% CI 0.92-9.11]), and those with any POPO compared with no POPO (5.05 [95% CI 2.45-10.43] vs 3.41 [95% CI 0.54-21.7]). CONCLUSION: In this cohort of children with newly-diagnosed CD, early anti-TNF demonstrated superior effectiveness in high-risk patients. | en_US |
dc.format.extent | 738 - 750 | |
dc.language | eng | |
dc.publisher | Oxford University Press | en_US |
dc.relation.ispartof | J Crohns Colitis | |
dc.rights | This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited. | |
dc.subject | Biologics | en_US |
dc.subject | early treatment | en_US |
dc.subject | inflammatory bowel disease | en_US |
dc.subject | risk-stratification | en_US |
dc.subject | Adolescent | en_US |
dc.subject | Child | en_US |
dc.subject | Female | en_US |
dc.subject | Humans | en_US |
dc.subject | Male | en_US |
dc.subject | Adalimumab | en_US |
dc.subject | Crohn Disease | en_US |
dc.subject | Gastrointestinal Agents | en_US |
dc.subject | Infliximab | en_US |
dc.subject | Prospective Studies | en_US |
dc.subject | Remission Induction | en_US |
dc.subject | Severity of Illness Index | en_US |
dc.subject | Treatment Outcome | en_US |
dc.subject | Tumor Necrosis Factor-alpha | en_US |
dc.subject | Child, Preschool | en_US |
dc.title | Improved Clinical Outcomes With Early Anti-Tumour Necrosis Factor Alpha Therapy in Children With Newly Diagnosed Crohn's Disease: Real-world Data from the International Prospective PIBD-SETQuality Inception Cohort Study. | en_US |
dc.type | Article | en_US |
dc.rights.holder | © The Author(s) 2023. Published by Oxford University Press on behalf of European Crohn’s and Colitis Organisation. | |
dc.identifier.doi | 10.1093/ecco-jcc/jjad197 | |
pubs.author-url | https://www.ncbi.nlm.nih.gov/pubmed/38011797 | en_US |
pubs.issue | 5 | en_US |
pubs.notes | Not known | en_US |
pubs.publication-status | Published | en_US |
pubs.volume | 18 | en_US |
rioxxterms.funder | Default funder | en_US |
rioxxterms.identifier.project | Default project | en_US |
qmul.funder | PIBD-SET Quality Inception Cohort and Safety Registry::European Union - Horizon 2020 | en_US |
rioxxterms.funder.project | b215eee3-195d-4c4f-a85d-169a4331c138 | en_US |