- In children with IBD, the prevalence of TNF inhibitor (TNFi) therapy increased 5-fold over a decade (2007-2017) while the surgical resection rate fell from 7% to 1.5%.
- TNFi prevalence per year was the only factor associated with fewer surgical resections.
Why this matters
- TNFi therapy may be modifying the natural history of pediatric IBD.
- Retrospective cohort of 825 children
- Funding: None disclosed.
- Mean age at diagnosis was 13.6 years.
- From 2007 to 2017, the prevalence of TNFi-treated patients rose from 5.05% to 27.1% (P=.0001) while the surgical resection rate fell from 7.07% to 1.46% (P=.001).
- On multivariate analysis, TNFi prevalence per year was the only factor associated with fewer surgical resections (P=.011).
- The reduction in surgical resections was driven by patients with Crohn's disease (8.9%-2.3%; P=.001), but not ulcerative colitis.
- There was no decline in rate of perianal surgeries.
- Time from diagnosis to resection rose from 1.64 to 2.78 years (P=.002), but there was no change in mean age at resection.
- Retrospective observational design.