Anti-TNF therapy is associated with decreased imaging and radiation exposure in patients with Crohns disease
Inflammatory Bowel Disease, 05/09/2012Patil SA et al.
Initiation of anti–TNF therapy for treatment of Crohn's disease (CD) is associated with a significant reduction in diagnostic radiation exposure. Conversely, steroid treatment does not reduce diagnostic radiation exposure.
The authors conducted a retrospective review of 99 CD patients initiated on anti-TNF therapy or corticosteroids between 2004 and 2009 in a tertiary care center.
Sixty-five patients were initiated on anti-TNF agents and 34 were initiated on corticosteroids.
The anti-TNF cohort was significantly younger at diagnosis and at the time of initiation of anti-TNF or steroid therapy.
The anti-TNF group had significantly more stricturing, penetrating, and perianal disease than the corticosteroid group.
The anti-TNF cohort had a significant reduction in number of radiologic exams (5.5 vs. 3.7, P<0.01) as well as a significant reduction in the cumulative radiation dose (28.1 vs. 15.0 mSv, P<0.01) the year after initiation of therapy.
This reduction was largely attributable to decreased use of computed tomography (CT) scans.
In contrast, there was no significant change in radiation exposure in the corticosteroid cohort.
Logistic regression analysis showed a strong trend toward higher exposure in patients with complicated disease behavior (stricturing or penetrating phenotype) (odds ratio [OR] 2.87, 95% confidence interval [CI] 0.98-8.38).
MDLinx connects healthcare professionals and patients to tomorrow's important medical news, while providing the pharmaceutical and healthcare industries with highly targeted interactive marketing, education, content, and medical research solutions.