Intest Res.  2019 Jan;17(1):94-106. 10.5217/ir.2018.00048.

Long-term prognosis of Japanese patients with biologic-naïve Crohn’s disease treated with anti-tumor necrosis factor-α antibodies

Affiliations
  • 1Division of Gastroenterology, Department of Internal Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan. kendo@med.tohoku.ac.jp
  • 2Division of Gastroenterology and Hepatology, Tohoku Medical and Pharmaceutical University, Sendai, Japan.

Abstract

BACKGROUND/AIMS
Few reports have described the long-term treatment outcomes of the anti-tumor necrosis factor-α antibody for Japanese Crohn's disease (CD) patients. The aim of this study was to evaluate them and clarify the clinical factors that affect the long-term prognosis of the anti-tumor necrosis factor-α treatments.
METHODS
This was a retrospective, observational, single-center cohort study. Japanese CD patients treated with either infliximab or adalimumab as a first-line therapy were analyzed. The cumulative retention rates of the biologics, relapse-free survival, and surgery-free survival were analyzed using Kaplan-Meier methods. The clinical factors associated with the long-term outcomes were estimated by both the log-rank test and Cox proportional hazard model.
RESULTS
The cumulative retention rate was significantly higher in the group with a concomitant elemental diet of ≥900 kcal/day, baseline C-reactive protein (CRP) levels < 2.6 mg/dL, and baseline serum albumin levels ≥3.5 g/dL, respectively. The baseline serum albumin levels were also associated with both relapse-free and surgery-free survival. The lack of concomitant use of an elemental diet ≥900 kcal/day was identified as the only independent risk factor for the withdrawal of the biologics.
CONCLUSIONS
Baseline CRP levels and serum albumin levels could affect the long-term outcomes in CD patients. Concomitant elemental diet of ≥900 kcal/day could have a positive influence on clinical treatment course.

Keyword

Crohn disease; Infliximab; Adalimumab; Long-term prognosis

MeSH Terms

Adalimumab
Antibodies*
Asian Continental Ancestry Group*
Biological Products
C-Reactive Protein
Cohort Studies
Crohn Disease
Food, Formulated
Humans
Infliximab
Necrosis*
Prognosis*
Proportional Hazards Models
Retrospective Studies
Risk Factors
Serum Albumin
Adalimumab
Antibodies
Biological Products
C-Reactive Protein
Infliximab
Serum Albumin
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