Early Biologic Therapy Boosts Healing in Crohn’s Disease

TOPLINE:
Early initiation of biologic therapy in patients with Crohn’s disease (CD) is associated with higher rates of transmural healing and leads to improved long-term outcomes.
METHODOLOGY:
In CD, early initiation of biologic therapy (within 12 months of diagnosis) has shown higher rates of clinical remission and lower rates of relapse than late initiation (> 12 months from diagnosis).
A retrospective study assessed the impact of the timing of biologic therapy initiation on transmural healing rates and long-term outcomes in adult patients diagnosed with CD from 1975 to 2022.
The primary outcome was the achievement of transmural healing, assessed using magnetic resonance enterography (MRE) at 12 ± 6 months post-therapy initiation and defined as the complete normalization of all MRE parameters (eg, absence of intestinal inflammation and CD-related complications).
The secondary long-term outcomes included bowel damage progression, CD-related surgery and hospitalization, and therapy escalation.
TAKEAWAY:
Researchers included 154 patients (median age at diagnosis, 26 years; 51% women) with CD, among whom 59 (38%) and 95 (62%) had early and late initiation of biologic therapy, respectively.
Patients with early initiation of biologic therapy were 3.23 times more likely to achieve transmural healing than those with late initiation (P < .01).
Achieving transmural healing was associated with reduced risk for bowel damage progression (adjusted hazard ratio [aHR], 0.28; P = .02), CD-related intestinal surgery (aHR, 0.21; P = .03), and therapy escalation (aHR, 0.35; P = .02).
Those with early initiation of biologic therapy also showed better MRE response rates than those with late initiation (36% vs 22%; P = .047).
IN PRACTICE:
“Our findings underscore the significance of initiating biological treatment within the first year of diagnosis for achieving higher [transmural healing] rates,” the authors wrote.
SOURCE:
The study, led by Joana Revés, Gastroenterology Department, Hospital Beatriz Ângelo, Loures, Portugal, was published online in Clinical Gastroenterology and Hepatology.
LIMITATIONS:
The retrospective nature of the study might have introduced information bias. Local assessment of radiological exams without central reading could have led to inconsistencies in the evaluation of transmural healing. The inclusion of patients with prior biologic therapy might have affected the definition of early biologic treatment.
DISCLOSURES:
This study did not report any source of funding. Some authors reported being speakers and consultants, advisory board members, and/or receiving research grants, consulting fees, lecture fees, and grants for traveling and educational activities from several pharmaceutical companies.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
 
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