Most Read Articles
2 days ago
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Pearl Toh, 6 days ago
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Immunomodulator therapy does not alter efficacy of anti-TNF for Crohn’s disease

06 Oct 2018
Crohn’s is not the end of the world, as Kathleen Baker’s silver medal proves

Antitumour necrosis factor (anti-TNF) with or without concurrent immunomodulator (IM) therapy result in comparable outcomes for patients with Crohn’s Disease (CD) or CD-like (CDL) conditions, a new meta-analysis reports.

A total of nine studies were eligible for inclusion in the meta-analysis, resulting in a cumulative sample size of 175 (mean age 26.5 years; 48 percent female). The complete clinical response rates for those treated with anti-TNF with and without IM were 67 percent and 88 percent, respectively.

Pooled analysis from three retrospective studies showed that compared to treatment with concurrent IM, anti-TNF monotherapy was not significantly different in terms of complete clinical response rate (risk ratio [RR], 0.58; 95 percent CI, 0.13–2.54; p=0.5).

The same was true for partial clinical response rates. Cumulative data from two retrospective studies revealed no significant difference between monotherapy and co-therapy with IM (RR, 0.98; 0.52–1.83; p=0.94).

Only one study compared anti-TNF monotherapy and co-therapy with IM in terms of remission rates. All participants achieved endoscopic and deep remission.

In terms of safety, anti-TNF monotherapy was nominally more likely to induce major adverse events than co-therapy with IM, though the association did not reach significance (RR, 3.89; 0.92–16.45; p=0.09). A similar trend was observed for minor adverse events (RR, 3.07; 0.7–13.52; p=0.28).

Stratifying the analysis according to the duration of follow-up did not result in meaningful changes in the primary findings about complete treatment response (follow-up <1 year: RR, 1.17; 0.07–18.96; p=0.91; follow-up >1 year; RR, 0.45; 0.07–2.7; p=0.38).

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Most Read Articles
2 days ago
Use of potassium citrate and thiazides appears to improve health-related quality of life (HRQOL) among stone formers across all Wisconsin Stone Quality of Life (WISQOL) domains without increasing the likelihood of gastrointestinal complaints and fatigue or sexual complaints, respectively, reports a study.
Pearl Toh, 6 days ago
First-line therapy with the BTK* inhibitor ibrutinib plus the anti-CD20 immunotherapy rituximab confers significant survival advantage over the current gold-standard regimen of fludarabine, cyclophosphamide, and rituximab (FCR) for young, fit patients with treatment-naïve chronic lymphocytic leukaemia (CLL), according to the E1912 trial, a large cooperative group study supported by the US National Cancer Institute.
4 days ago
Eating high amounts of red and processed meat prior to a diagnosis of colorectal cancer appears to be associated with shorter survival time, although a possible weak association cannot be excluded, a study has shown.
3 days ago
Middle-aged Caucasian men who are dissatisfied with their marriage are at higher risk of sudden cardiac death regardless of other cardiovascular risk factors, a new study reports.