Journal
DIGESTIVE DISEASES AND SCIENCES
Volume 68, Issue 3, Pages 877-888Publisher
SPRINGER
DOI: 10.1007/s10620-022-07604-7
Keywords
Abscess; Phlegmon; Inflammatory mass; Anti-tumor-necrosis-factor-alpha; Crohn's disease
Categories
Ask authors/readers for more resources
This study aimed to describe the multidisciplinary management of pediatric patients with internally penetrating Crohn's Disease complications and explore the effectiveness and safety of Anti-TNF therapy prior to complication resolution. The study results suggest that initiating Anti-TNF therapy before complication resolution may be a safe and effective strategy to improve clinical outcomes.
Background Internally penetrating Crohn's Disease complications, including abscesses and phlegmon, represent a high-risk Crohn's Disease phenotype. Anti-tumor-necrosis-factor-alpha (Anti-TNF) therapies are effective in treating penetrating Crohn's Disease and early initiation has shown unique benefits. However, timing of anti-TNF initiation in the setting of internally penetrating Crohn's Disease complications is typically heterogenous due to concern over precipitating serious infections. Recent studies demonstrate such an association may not exist. Aims We aimed to describe the multidisciplinary management of pediatric patients with internally penetrating Crohn's Disease complications, focusing on the utilization and timing of anti-TNF therapy relative to complication resolution and adverse events. Methods We performed a single-center retrospective cohort study of pediatric patients with internally penetrating Crohn's Disease complications from 2007 to 2021. The safety and effectiveness of anti-TNF therapy initiation prior to complication resolution was assessed by comparing rates of infectious and Crohn's Disease-related adverse events between those who received anti-TNF therapy prior to complication resolution, versus those who did not. Results Twenty-one patients with internally penetrating Crohn's Disease complications were identified. 7/21 received anti-TNF therapy prior to complication resolution. Infectious adverse events within 90 days of complication occurred in 0/7 patients initiating anti-TNF therapy prior to complication resolution and 10/14 patients who did not (p = 0.004). Crohn's Disease-related surgeries and hospitalizations within 1 year of complication occurred in 12/20 patients, with similar frequency between groups. Conclusions Initiating anti-TNF therapy prior to internally penetrating Crohn's Disease complication resolution may be a safe and effective strategy to improve clinical outcomes.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available