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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
No association exists between physical activity and the risk of urological cancer, according to a population-based prospective study in Japan.
12 Feb 2019
Olanzapine confers a modest therapeutic effect on weight compared with placebo in adult outpatients with anorexia nervosa, a study has shown. However, it does not appear to offer significant benefit for psychological symptoms.
3 days ago
Patients with childhood-onset inflammatory bowel disease are more likely to die than the general population, a study suggests.
3 days ago
Reduced caloric intake results in a significant improvement in glucose metabolism and body-fat composition, including liver-fat content, according to a study. Changes in ferritin levels appear to mediate the striking reduction in liver fat.