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Efficacy of early immunomodulator therapy on the outcomes of Crohn’s disease

 Min Seob Kwak  ;  Duk Hwan Kim  ;  Soo Jung Park  ;  Tae Il Kim  ;  Sung Pil Hong  ;  Won Ho Kim  ;  Jae Hee Cheon 
 BMC GASTROENTEROLOGY, Vol.14(1) : 85, 2014 
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Adolescent ; Adrenal Cortex Hormones/therapeutic use ; Adult ; Azathioprine/therapeutic use* ; C-Reactive Protein/immunology ; Cohort Studies ; Crohn Disease/drug therapy* ; Crohn Disease/immunology ; Early Medical Intervention* ; Female ; Humans ; Immunologic Factors/therapeutic use ; Immunosuppressive Agents/therapeutic use* ; Kaplan-Meier Estimate ; Logistic Models ; Male ; Mercaptopurine/therapeutic use* ; Remission Induction ; Retrospective Studies ; Treatment Outcome ; Young Adult
Crohn’s disease ; Azathioprine ; 6-mercaptopurine ; Immunomodulator
BACKGROUND: The natural course of Crohn's disease (CD), with continuing relapses and remissions, leads to irreversible intestinal damage. Early adoption of immunomodulator therapy has been proposed in order to address this; however, it is still uncertain whether early immunomodulator therapy could affect the natural course of the disease in real practice. We evaluated the efficacy of such therapy on the prognosis of newly diagnosed patients with CD. METHODS: This retrospective study included 168 patients who were newly diagnosed with CD and who started treatment at Severance Hospital, Seoul, Korea between January 2006 and March 2013. The short- and long-term outcomes were compared between patients treated with early immunomodulator therapy and those treated with conventional therapy. RESULTS: A Kaplan-Meier analysis identified that administration of immunomodulators within 6 months after diagnosis of CD was superior to conventional therapy in terms of clinical remission and corticosteroid-free remission rates (P=0.043 and P=0.035). However, P=0.827). Patients with a baseline elevated CRP level were more likely to relapse (P<0.005). Drug-related adverse events were more frequent in the early immunomodulator therapy group than in the conventional therapy group P=0.029). CONCLUSIONS: Early immunomodulator therapy was more effective than conventional therapy in inducing remission, but not in preventing relapse. Baseline high CRP level was a significant indicator of relapse.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Duk Hwan(김덕환)
Kim, Won Ho(김원호) ORCID logo https://orcid.org/0000-0002-5682-9972
Kim, Tae Il(김태일) ORCID logo https://orcid.org/0000-0003-4807-890X
Park, Soo Jung(박수정)
Cheon, Jae Hee(천재희) ORCID logo https://orcid.org/0000-0002-2282-8904
Hong, Sung Pil(홍성필)
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