Long-term prognosis of Japanese patients with biologic-naïve Crohn’s disease treated with anti-tumor necrosis factor-α antibodies
- Author:
Rintaro MOROI
1
;
Katsuya ENDO
;
Katsutoshi YAMAMOTO
;
Takeo NAITO
;
Motoyuki ONODERA
;
Masatake KUROHA
;
Yoshitake KANAZAWA
;
Tomoya KIMURA
;
Yoichi KAKUTA
;
Atsushi MASAMUNE
;
Yoshitaka KINOUCHI
;
Tooru SHIMOSEGAWA
Author Information
- Publication Type:Original Article
- Keywords: Crohn disease; Infliximab; Adalimumab; Long-term prognosis
- MeSH: 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
- From:Intestinal Research 2019;17(1):94-106
- CountryRepublic of Korea
- Language:English
- 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.
