Significant advantages for first line treatment with TNF-alpha inhibitors in pediatric patients with inflammatory bowel disease – Data from the multicenter CEDATA-GPGE registry study

Claßen M, de Laffolie J, Claßen M, Schnell A, Sohrabi K, Hörning A (2022)

Publication Type: Journal article

Publication year: 2022

Journal

Frontiers in Pediatrics Frontiers Media

Book Volume: 10

Article Number: 903677

DOI: 10.3389/fped.2022.903677

Abstract

Background and aims: In recent years, biological agents, such as anti-TNF-α blockers, have been introduced and have shown efficacy in pediatric patients with inflammatory bowel disease (IBD). Here, the prescription mode differentiated into a first/second line application, and efficacy and side effects are evaluated beginning from 2004 until today. Methods: Statistical analyses of the prospective and ongoing CEDATA multicenter registry data from the Society of Pediatric Gastroenterology and Nutrition (GPGE) were performed for patients receiving a biological agent at least once during the period from June 2004 until November 2020 (n = 487). The analyzed parameters were patient demographics, disease extent and behavior, prior or concurrent therapies, duration and outcome of biological therapy, disease-associated complications, drug-related complications, laboratory parameters and treatment response as determined by the Physician’s Global Assessment. Results: Crohn’s disease (CD) was present in 71.5% of patients, and 52% were boys. Patients showed high disease activity when receiving a first-line TNF-α blocker. After 2016, patients who failed to respond to anti-TNF-α induction therapy were treated with off-label biologics (vedolizumab 4.3% and ustekinumab 2.1%). Propensity score matching indicated that patients with CD and higher disease activity benefitted significantly more from early anti-TNF-α therapy. This assessment was based on a clinical evaluation and lab parameters related to inflammation compared to delayed second-line treatment. Additionally, first-line treatment resulted in less treatment failure and fewer extraintestinal manifestations during TNF-α blockade. Conclusion: First-line treatment with anti-TNF-α drugs is effective and safe. An earlier start significantly reduces the risk of treatment failure and is associated with fewer extraintestinal manifestations during longitudinal follow-up.

Authors with CRIS profile

Merle Claßen Lehrstuhl für Kinder- und Jugendmedizin Alexander Schnell Department of Paediatrics and Adolescent Medicine André Hörning Department of Paediatrics and Adolescent Medicine

Involved external institutions

Klinikverbund Bremen (Gesundheit Nord) DE Germany (DE) Justus-Liebig-Universität Gießen DE Germany (DE)

How to cite

APA:

Claßen, M., de Laffolie, J., Claßen, M., Schnell, A., Sohrabi, K., & Hörning, A. (2022). Significant advantages for first line treatment with TNF-alpha inhibitors in pediatric patients with inflammatory bowel disease – Data from the multicenter CEDATA-GPGE registry study. Frontiers in Pediatrics, 10. https://doi.org/10.3389/fped.2022.903677

MLA:

Claßen, Merle, et al. "Significant advantages for first line treatment with TNF-alpha inhibitors in pediatric patients with inflammatory bowel disease – Data from the multicenter CEDATA-GPGE registry study." Frontiers in Pediatrics 10 (2022).

BibTeX: Download