Accelerated treatment keeps Crohn's disease in check up to 24 months

Kathleen Blanchard's picture
Accelerated care best for Crohn's disease: REACT trial results
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Results of an international trial suggest accelerated treatment is best for treating Crohn's disease. Research that included almost 2,000 patients in the REACT ( Randomized Evaluation of an Algorithm for Crohn's Treatment) clinical trial shows Crohn's treatment should start early versus management according to symptoms.

The finding is important for anyone with Crohn's disease, especially those who are newly diagnosed. The disease can interfered with lifestyle, causes pain and can affect any part of of the gastrointestinal tract, including the mouth and lips. Many patients with Crohn's also develop skin problems that can interfere with daily activities. Crohn's disease takes a toll on the ability to socialize and enjoy life fully.

Dr. Brian Feagan, CEO and Senior Scientific Director of Robarts Clinical Trials and a professor in the Division of Gastroenterology at Western's Schulich School of Medicine & Dentistry explains Crohn's disease treatment has changed dramatically with the introduction of TNF antagonists like adalimumab and infliximab.

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With the new "accelerated care" approach that involves starting immunotherapy early high risk patients achieve and maintain greater remission, take fewer steroids, have less frequent hospitalizations and less chance of needing surgery.

"However, adoption of these key concepts by community gastroenterologists has been relatively slow," says Dr. Feagan in a February, 2014 press release. "This is primarily because many believe that the safety and efficacy of these agents may not be generalizable to their individual practice, since they were tested in academic centers. The REACT study was designed to address these concerns."

The study results showed:

  • Treating Crohn's disease based on symptoms may be sub-optimal
  • Early therapy with a combination of TNF agents and azathioprine or methotrexate used early in the course of Crohn's disease is safe and feasible
  • The accelerated care approach may be more effective than treating Crohn's disease symptoms

Patients with Crohn's disease given the combined immunotherapy had lower hospitalizations, surgeries and complications for up to 24 months in the study finding.

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