Tight control in Crohn’s treatment is tied to less hospital time, more remission

  • Panaccione R & al.
  • Gut
  • 8 Jul 2019

  • International Clinical Digest
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Takeaway

  • Patients with Crohn’s disease (CD) treated using a “tight control” (TC) approach based on inflammatory biomarker and clinical symptom monitoring spend less time in hospitals and more time in remission than those treated using a symptom-based clinical management (CM) approach, boosting cost-effectiveness.

Why this matters

  • Physicians should consider a TC strategy when treating patients with moderate-to-severe active CD.

Study design

  • Researchers analyzed data from a randomized clinical trial comparing TC with CM in patients treated with adalimumab (Humira), prednisone, and azathioprine (n=244; mean age, 31.60±11.7 years; 57.8% women; 92.6% white).
  • They used regression models to predict health states, treatment effects, hospitalizations, and costs.
  • Funding: AbbVie (maker of Humira), which approved and reviewed the analysis before publication.

Key results

  • When compared with CM, TC was linked to a higher clinical remission rate (58.2% vs 46.8%), fewer CD-related hospitalizations (0.124 vs 0.297 times per patient), and more injections of adalimumab (mean, 31.01 vs 24.74).

Limitations

  • Trial data may not be generalizable to patients with long CD treatment histories.
  • Cost-effectiveness analysis may not apply to countries other than the United Kingdom.

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