Early Combined Immunosuppression Reduces Complications in Long-standing Crohn's Disease: A Post Hoc Analysis of REACT

Jurij Hanzel; Christopher Ma; Guangyong Zou; Siddharth Singh; Parambir S Dulai; Brian G Feagan; Geert R D'Haens; William J Sandborn; Vipul Jairath

doi:10.1016/j.cgh.2020.12.019

Early Combined Immunosuppression Reduces Complications in Long-standing Crohn's Disease: A Post Hoc Analysis of REACT

Clin Gastroenterol Hepatol. 2022 Jan;20(1):236-238. doi: 10.1016/j.cgh.2020.12.019. Epub 2020 Dec 18.

Authors

Jurij Hanzel¹, Christopher Ma², Guangyong Zou³, Siddharth Singh⁴, Parambir S Dulai⁵, Brian G Feagan⁶, Geert R D'Haens⁷, William J Sandborn⁸, Vipul Jairath⁹

Affiliations

¹ Department of Gastroenterology, UMC Ljubljana, University of Ljubljana, Ljubljana, Slovenia; Alimentiv Inc, London, Ontario, Canada.
² Alimentiv Inc, London, Ontario, Canada; Division of Gastroenterology and Hepatology, University of Calgary, Calgary, Alberta, Canada.
³ Alimentiv Inc, London, Ontario, Canada; Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada.
⁴ Division of Gastroenterology, University of California, San Diego, La Jolla, California; Division of Biomedical Informatics, University of California, San Diego, La Jolla, California.
⁵ Division of Gastroenterology, University of California, San Diego, La Jolla, California.
⁶ Alimentiv Inc, London, Ontario, Canada; Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada; Division of Gastroenterology, Western University, London, Ontario, Canada.
⁷ Alimentiv Inc, London, Ontario, Canada; Department of Gastroenterology and Hepatology, Amsterdam University Medical Centre, Academic Medical Centre, Amsterdam, Netherlands.
⁸ Alimentiv Inc, London, Ontario, Canada; Division of Gastroenterology, University of California, San Diego, La Jolla, California.
⁹ Alimentiv Inc, London, Ontario, Canada; Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada; Division of Gastroenterology, Western University, London, Ontario, Canada. Electronic address: vjairath@uwo.ca.

PMID: 33346141
DOI: 10.1016/j.cgh.2020.12.019

Abstract

Crohn's disease (CD) can lead to bowel damage, stricturing, and obstruction thereby resulting in surgery and hospitalization. The Randomized Evaluation of an Algorithm for Crohn's Treatment (REACT) trial showed that early combined immunosuppression (ECI) with symptom-based treatment escalation for 24 months resulted in a lower risk of surgery, hospitalization, or CD-related complications compared with conventional management (CM).¹ Treatment earlier in the disease course may be associated with reduced risk of complications compared with later initiation, although data are sparse.² We performed a post hoc analysis of REACT to evaluate the impact of baseline disease duration on surgery, hospitalization, or CD-related complications in patients treated with ECI compared with CM.

Publication types

Randomized Controlled Trial

MeSH terms

Algorithms
Constriction, Pathologic / complications
Crohn Disease* / complications
Crohn Disease* / drug therapy
Crohn Disease* / surgery
Humans
Immunosuppression Therapy / adverse effects
Intestines