Type

Journal Article

Authors

Glen A Doherty
Dermot E Malone
Garret Cullen
Hugh E Mulcahy
Kathryn Byrne
Denise Keegan
Sinead H McEvoy
Anna E Smyth
David J Murphy
David J Gibson

Subjects

Medicine & Nursing

Topics
clinical crohn s disease treatment resonance necrosis multivariate analysis treatment failure follow up treatment outcome

Magnetic resonance enterography findings as predictors of clinical outcome following antitumor necrosis factor treatment in small bowel Crohn's disease. (2015)

Abstract To determine whether specific magnetic resonance enterography (MRE) findings can predict outcome following commencement of antitumor necrosis factor (aTNF) in small bowel Crohn's disease (CD) PATIENTS AND METHODS: This was a single-centre retrospective study of patients with CD who commenced aTNF (infliximab or adalimumab) between 2007 and 2013. Patients who had an MRE within 6 months before commencing aTNF were included. The primary end-point was the need for CD-related surgery. The secondary end-points were time to surgery and time to treatment failure. The relationship between these end-points, clinical variables and specific MRE findings were studied. Four hundred and eighteen patients commenced aTNF for CD during the study period. Seventy-five patients had an MRE within 6 months before commencing aTNF (30 infliximab; 45 adalimumab). The median time from MRE to commencing aTNF was 43 days (IQR 19.5-87 days). Eighteen of 75 (24%) had surgery during a median follow-up of 16.7 months (IQR 9.0-30.1 months). Patients with small bowel stenosis (SBS) on MRE were at a significantly higher risk of requiring surgery: 12/18 (66.7%) versus 6/57 (10.5%) (P<0.001). Time to surgery was significantly shorter in patients with SBS on MRE (P<0.001). In a multivariate analysis, SBS (P<0.0001, hazard ratio 26.45, 95% confidence interval 5.45-128.49) and presence of penetrating complications (P=0.003, hazard ratio 36.53, 95% confidence interval 3.40-393.19) were associated independently with time to surgery. SBS and penetrating complications on MRE are associated independently with a need for early surgery and treatment failure in patients commencing aTNF.
Collections Ireland -> University College Dublin -> PubMed

Full list of authors on original publication

Glen A Doherty, Dermot E Malone, Garret Cullen, Hugh E Mulcahy, Kathryn Byrne, Denise Keegan, Sinead H McEvoy, Anna E Smyth, David J Murphy, David J Gibson

Experts in our system

1
Glen A Doherty
University College Dublin
Total Publications: 57
 
2
Garret Cullen
University College Dublin
Total Publications: 17
 
3
Hugh E Mulcahy
University College Dublin
Total Publications: 43
 
4
Kathryn Byrne
University College Dublin
Total Publications: 16
 
5
Denise Keegan
University College Dublin
Total Publications: 22
 
6
David J Murphy
University College Dublin
Total Publications: 4
 
7
David J Gibson
University College Dublin
Total Publications: 7