ArticlePloS one2017
Early anti-TNF/immunomodulator therapy is associated with better long-term clinical outcomes in Asian patients with Crohn's disease with poor prognostic factors.
Article in PloS one, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 2 of them syntheses that pooled it.
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Who cites it
23 citing papers in PubMed, 2 syntheses or guidelines pooled it, 42 citations in OpenAlex.
- Early Biologic Treatment Decreases Risk of Surgery in Crohn's Disease but not in Ulcerative Colitis: Systematic Review and Meta-Analysis.Inflammatory bowel diseases · 2024Pooled it
- Systematic review and meta-analysis: efficacy and safety of early biologic treatment in adult and paediatric patients with Crohn's disease.Alimentary pharmacology & therapeutics · 2020Pooled it
- Differential Outcomes of Early Versus Late Anti-TNF Therapy in Ulcerative Colitis and Crohn's Disease: A Nationwide Propensity Score-Matched Cohort Study.United European gastroenterology journal · 2025Article
- Nationwide study on clinical impact of early tumor necrosis factor-α inhibitors following first intestinal resection in biologics-naïve Crohn's disease patients.Scientific reports · 2025Article
- Comparison of 1-Year Clinical Course in Patients With Newly Diagnosed Inflammatory Bowel Disease Between Vietnam and Korea: A Multinational, Multicenter Retrospective Cohort Study.JGH open : an open access journal of gastroenterology and hepatology · 2025Article
- Crohn's disease and clinical management today: How it does?World journal of methodology · 2023Review
- Earlier anti-TNF therapy reduces the risk of malnutrition associated with alterations in body composition in patients with Crohn's disease.Frontiers in nutrition · 2023Article
- Can we change the natural course of inflammatory bowel disease?Therapeutic advances in gastroenterology · 2023Review
- A scoping review on early inflammatory bowel disease: definitions, pathogenesis, and impact on clinical outcomes.Therapeutic advances in gastroenterology · 2022Article
- The Effect of Early vs Delayed Initiation of Adalimumab on Remission Rates in Patients With Crohn's Disease With Poor Prognostic Factors: The MODIFY Study.Crohn's & colitis 360 · 2021Article
- The Impact of Intestinal Complications on Health Care Costs Among Patients With Inflammatory Bowel Disease Treated With Anti-Tumor Necrosis Factor Therapies.Inflammatory bowel diseases · 2021Article
- Observational
- Radiological Response Is Associated with Better Outcomes and Should Be Considered a Therapeutic Target in Crohn's Disease.Digestive diseases and sciences · 2020Article
- Impact of early anti-TNF use on clinical outcomes in Crohn's disease: a nationwide population-based study.The Korean journal of internal medicine · 2020Article
- Similar Clinical Outcomes of Early and Late Anti-TNF Initiation for Ulcerative Colitis: A Nationwide Population-Based Study.Yonsei medical journal · 2020Article
- Observational
- The Future of Biosimilars: Maximizing Benefits Across Immune-Mediated Inflammatory Diseases.Drugs · 2020Review
- Earlier Anti-Tumor Necrosis Factor Therapy of Crohn's Disease Correlates with Slower Progression of Bowel Damage.Digestive diseases and sciences · 2019Article
- Current Status of Segmental Colectomy in Select Crohn's Disease Patients.Clinics in colon and rectal surgery · 2019Review
- Best practices on immunomodulators and biologic agents for ulcerative colitis and Crohn's disease in Asia.Intestinal research · 2019Review
Corrections and comments
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Authors and funding
18 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Although early treatment of Crohn's disease (CD) patients with anti-tumor necrosis factor (TNF) agents or immunomodulators (IMs) may improve long-term outcomes, especially those with poor prognostic factors, their effectiveness in Asians remains unclear. In this study, Korean patients with CD naïve to both intestinal surgery and intestinal complications, and with at least two risk factors for progression (diagnosis at age <40 years, systemic corticosteroid treatment <3 months after diagnosis, and perianal fistula at diagnosis) were retrospectively analyzed. Patients were classified into those who started anti-TNFs, or IMs but not anti-TNFs, within 2 years of diagnosis, and those who started anti-TNFs and/or IMs later. Their probabilities of intestinal surgery and intestinal complications were compared. A total of 670 patients were enrolled, 79 in the early anti-TNF, 286 in the early IM, and 305 in the late treatment group. Kaplan-Meier analysis with the log-rank test showed that from starting anti-TNFs/IMs, times to intestinal surgery (P < 0.001), stricturing complications (P = 0.002), and penetrating complications (P < 0.001) were significantly longer in the early anti-TNF/IM groups than in the late treatment group. Multivariate Cox regression analysis showed that, from starting anti-TNFs/IMs, late anti-TNF/IM treatment was independently associated with higher risks of intestinal surgery (adjusted hazard ratio [aHR] 2.321, 95% confidence interval [CI] 1.503-3.584, P < 0.001), behavioral progression (aHR 2.001, 95% CI 1.449-2.763, P < 0.001), stricturing complications (aHR 1.736, 95% CI 1.209-2.493, P = 0.003), and penetrating complications (aHR 3.315, 95% CI 2.094-5.249, P < 0.001) than early treatment. In conclusion, treatment of Asian CD patients having poor prognostic factors with anti-TNFs/IMs within 2 years of diagnosis is associated with better clinical outcomes than later treatment.
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