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EnglishBackground: The Lémann Index (LI) was recently developed to evaluate the cumulative bowel damage in patients with Crohn's disease (CD).Aims: To search for a difference between adalimumab and azathioprine to halt the progression of bowel damage in active CD, using the LI.Methods: A single-centre, retrospective study was conducted. Patients with CD were included if they had colonoscopy and magnetic resonance enterography performed within 4 months from the start of adalimumab or azathioprine and repeated after 12 months of therapy. Primary outcome was reached if the increase of LI after 12 months of treatment was <0.3, the drug was not stopped, and the use of systemic steroids was continued for no more than 3 months.Results: Ninety-one patients were enrolled, 31 (34.1%) of them treated with adalimumab and 60 (65.9%) with azathioprine. Sixty-seven percent of patients treated with adalimumab reached the primary outcome compared to 28.3% of patients treated with azathioprine (p = .0006). The LI in the group on adalimumab therapy decreased after 12 months (from 9.9 to 8.8), while in the group on azathioprine therapy it increased (from 7.7 to 8.8).Conclusion: Treatment with adalimumab halts the progression of bowel damage in CD while that with azathioprine does not.
| Titolo: | Adalimumab versus azathioprine to halt the progression of bowel damage in Crohn’s disease: application of Lémann Index | |
| Autori Riconosciuti: | ||
| Autori: | Ribaldone D.G.; Caviglia G.P.; Pellicano R.; Vernero M.; Italia A.; Morino M.; Saracco G.M.; Astegiano M. | |
| Data di pubblicazione: | 2019 | |
| Abstract: | Background: The Lémann Index (LI) was recently developed to evaluate the cumulative bowel damage in patients with Crohn's disease (CD).Aims: To search for a difference between adalimumab and azathioprine to halt the progression of bowel damage in active CD, using the LI.Methods: A single-centre, retrospective study was conducted. Patients with CD were included if they had colonoscopy and magnetic resonance enterography performed within 4 months from the start of adalimumab or azathioprine and repeated after 12 months of therapy. Primary outcome was reached if the increase of LI after 12 months of treatment was <0.3, the drug was not stopped, and the use of systemic steroids was continued for no more than 3 months.Results: Ninety-one patients were enrolled, 31 (34.1%) of them treated with adalimumab and 60 (65.9%) with azathioprine. Sixty-seven percent of patients treated with adalimumab reached the primary outcome compared to 28.3% of patients treated with azathioprine (p = .0006). The LI in the group on adalimumab therapy decreased after 12 months (from 9.9 to 8.8), while in the group on azathioprine therapy it increased (from 7.7 to 8.8).Conclusion: Treatment with adalimumab halts the progression of bowel damage in CD while that with azathioprine does not. | |
| Volume: | 54 | |
| Fascicolo: | 11 | |
| Pagina iniziale: | 1339 | |
| Pagina finale: | 1345 | |
| Digital Object Identifier (DOI): | 10.1080/00365521.2019.1686057 | |
| URL: | http://www.tandfonline.com/loi/igas20 | |
| Parole Chiave: | Anti-TNF; colonoscopy; magnetic resonance enterography; small intestine; thiopurine | |
| Rivista: | SCANDINAVIAN JOURNAL OF GASTROENTEROLOGY | |
| Appare nelle tipologie: | 03A-Articolo su Rivista |
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