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KMID : 0988920190170010094
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Intestinal Research
2019 Volume.17 No. 1 p.94 ~ p.106
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Long-term prognosis of Japanese patients with biologic-naive Crohn’s disease treated with anti-tumor necrosis factor-α antibodies
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Moroi Rintaro
Endo Katsuya
Yamamoto Katsutoshi
Naito Takeo
Onodera Motoyuki
Kuroha Masatake
Kanazawa Yoshitake
Kimura Tomoya
Kakuta Yoichi
Masamune Atsushi
Kinouchi Yoshitaka
Shimosegawa Tooru
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Abstract
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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.
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KEYWORD
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Crohn disease, Infliximab, Adalimumab, Long-term prognosis
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