Early Infliximab in Crohn's is associated with decreased intestinal surgery and similar health care costs.
Scand J Gastroenterol
; 56(4): 397-402, 2021 Apr.
Article
em En
| MEDLINE
| ID: mdl-33595389
ABSTRACT
BACKGROUND:
Using Infliximab early in Crohn's disease can provide a window of opportunity in children for restoration of growth and achievement of puberty. We aimed to compare clinical outcomes and costs of a retrospective pediatric Crohn's disease (pCD) cohort treated with early use Infliximab (EUI) within 12 months compared with later use Infliximab (LUI).METHODS:
Retrospective review of all children with pCD commenced on Infliximab was undertaken in a tertiary Australian pediatric center.RESULTS:
pCD progressing to Infliximab was identified in 70 children 38 (54%) in the EUI cohort versus 32 (46%) in the LUI cohort. Intestinal surgery had a higher risk of occurring in EUI when compared with LUI (2 (5%) versus 9 (28%), HR 5.67 (95% CI 1.21-26.38); p = .027). No patients in EUI underwent intestinal surgery post Infliximab commencement compared with 3 (9%) in LUI (p = .09). Escalation of Infliximab in luminal Crohn's disease was not significantly different in EUI when compared with LUI (3 (10.3%) versus 9 (39.1%) (p = .1)). EUI was more frequently used than LUI in 2015-2018 (27 (71%) versus 14 (44%)) p = .029, with the inverse occurring in 2010-2014 (11 (29%) versus 18 (56%)). Hospital admissions per person per year in EUI and LUI were 43 (0.23 visits/person/year) versus 84 (0.67 visits/person/year); IRR 2.51 (95% CI 0.9-7.01); p = .078). Health costs were not significantly different between cohorts.CONCLUSION:
EUI in pCD is associated with an increased likelihood of being diagnosed in more recent years, less intestinal surgery and a trend toward decreased hospital admissions than LUI.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Doença de Crohn
Tipo de estudo:
Health_economic_evaluation
/
Observational_studies
/
Risk_factors_studies
Limite:
Child
/
Humans
País/Região como assunto:
Oceania
Idioma:
En
Revista:
Scand J Gastroenterol
Ano de publicação:
2021
Tipo de documento:
Article
País de afiliação:
Austrália