Earlier Anti-TNF Initiation Reduces Hospitalizations Among Patients With CD

A recent study found that downstream health care resource utilization is reduced for patients with Crohn disease (CD) who received earlier administration of anti-tumor necrosis factor (TNF) therapy. Similar impacts were not found among patients with ulcerative colitis (UC).

There has been recent concern that delaying the initiation of biologic therapy for patients with inflammatory bowel disease (IBD) could result in more treatment-resistant disease, and therefore, more complications and hospitalizations.

Using health administrative data from Manitoba, Canada, researchers identified all individuals with a new diagnosis of IBD between 2001 and 2018, who also received anti-TNF therapy and at least 1 year of follow-up after anti-TNF treatment. Outcomes measured were rates of hospitalization, surgery, and outpatient visits up to 5 years after initiation of the anti-TNF therapy. The rates of these outcomes were compared between patients who received anti-TNFs within 2 years following diagnosis of IBD and those who received anti-TNFs more than 2 years after diagnosis.

Of 1060 patients included in the study, 742 had CD and 318 had UC. Among those with CD, patients who initiated anti-TNF treatment within 2 years of diagnosis had fewer IBD-specific and overall hospitalizations over the 5 years following the start of therapy. Excluding the first year following initiation from analysis, these patients also had lower incidence of resective surgery. Of the patients with UC, the rates of hospitalization and surgery were not affected by the timing of anti-TNF therapy.

—Allison Casey

Reference:

Targownik LE, Bernstein CN, Benchimol EI, et al. Earlier anti-TNF initiation leads to long term lower health care utilization in Crohn’s disease but not in ulcerative colitis. Clin Gastroenterol Hepatol. Published online: March 3, 2022. doi:10.1016/j.cgh.2022.02.021