Long-term prognosis of Japanese patients with biologicnaïve Crohn's disease treated with anti-tumor necrosis factor-α antibodies

Rintaro Moroi, Katsuya Endo, Katsutoshi Yamamoto, Takeo Naito, Motoyuki Onodera, Masatake Kuroha, Yoshitake Kanazawa, Tomoya Kimura, Yoichi Kakuta, Atsushi Masamune, Yoshitaka Kinouchi, Tooru Shimosegawa

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)

Abstract

Background/Aims: Few reports have described the long-term treatment outcomes of the anti-tumor necrosis factor-a 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-a 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.

Original languageEnglish
Pages (from-to)94-106
Number of pages13
JournalIntestinal Research
Volume17
Issue number1
DOIs
Publication statusPublished - 2019 Jan 1

Keywords

  • Adalimumab
  • Crohn disease
  • Infliximab
  • Long-term prognosis

ASJC Scopus subject areas

  • Gastroenterology

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