Earlier Initiation of Biologic Therapy Reduces Crohn Disease Complications

Initiation of biologic therapy within 2 years of Crohn disease (CD) diagnosis decreases steroid use, number of hospitalizations and emergency room visits, and need for surgical procedures compared with later initiation of treatment, according to study results presented at the American College of Gastroenterology (ACG) 2022 Annual Meeting, held from October 21 to 26, 2022, in Charlotte, North Carolina, and virtually.

Clinicians prescribed biologic therapies to treat patients with moderate to severe CD. Biologics target inflammatory pathways, allowing for mucosal healing with the end goal of achieving clinical remission.

Researchers conducted a real-world, retrospective, cohort study of 343 patients treated for CD within the Military Health System from January 1, 2013 to December 30, 2020. They analyzed whether early initiation of biologic therapy within 2 years of CD diagnosis significantly altered disease progression by reducing CD-related complications and outcomes compared with patients who initiated biologic therapy more than 2 years after diagnosis.

In the study, 184 patients with CD initiated biologic therapy within 2 years of diagnosis, while 159 initiated biologic therapy 2 or more years after diagnosis.

Researchers compared radiologic, endoscopic/histologic, biochemical, and clinical findings between the 2 groups. They tracked the percentage of patients experiencing CD-related complications, such as emergency room visits, hospitalizations, steroid use, and surgeries.

As the researchers hypothesized, patients initiating biologic therapy within 2 years of CD diagnosis experienced significantly fewer CD-related complications compared with patients who initiated biologic treatment later (P <.0001).

In addition to timing of initiation of biologic therapy, 2 other factors increased the risk of CD-related complications — signs of perianal disease at time of CD diagnosis and previous use of thiopurine monotherapy before initiation of biologics.

“This real-world study is one of the first to confirm prior clinical trial data on decreased complications in early initiation of biologic therapy in CD patients,” the study authors wrote.

Disclosures: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.