For a study, the researchers sought to determine how pediatric Crohn’s disease (CD) patients were handled and diagnosed before and after 2014. In the study, they determined whether the implementation and the consequent increased the use of an upfront anti-tumor necrosis factor therapy. A retrospective study of all children diagnosed with CD from January 2010 to December 2018 was conducted at a single center. Patients diagnosed between 2010 and 2014 (group 1) were compared to those diagnosed after that year (group 2). At baseline and every 6 months, the number of relapses, the occurrence of complications, the therapy received, biological data, and any endoscopic or radiologic evaluation were recorded for each patient. About 154 individuals were included in the study, with 78 (51%) of them being diagnosed after 2014. For patients treated according to the guidelines, the cumulative chance of a relapse-free and surgery-free course was considerably greater (log-rank hazard ratio [HR] = 1,818, P=0.003 and HR = 3,15, 95% CI, P=0.04, respectively). At 1 and 2 years, the mucosal healing rate was considerably greater in group 2 patients (P=0.04 and P=0.05, respectively), but there was no significant difference in transmural healing rates or the risk of sequelae. The 2014 CD guidelines appear to impact disease outcomes, with a significantly lower chance of relapse and surgery. Still, no effect on the risk of developing comorbidities was identified.

Source:journals.lww.com/jpgn/Abstract/2022/01000/Increased_Use_of_Anti_Tumor_Necrosis_Factor.14.aspx