Early Initiation of Anti-Tnf is Associated with Favourable Long-Term Outcome in Crohn's Disease: 10-Year-Follow-Up Data from the Swiss IBD Cohort Study.

BACKGROUND AND AIMS The optimal timing of treatment escalation in Crohn's disease (CD) remains a challenge and very little is known about its long-term development following early versus late administration of anti-TNF antibodies. The long-term outcome of Swiss CD patients was comparatively assessed in an up to 10-year follow-up, using patients participating in the Swiss Inflammatory Bowel Disease Cohort Study (SIBDCS). METHODS Prospectively-collected SIBDCS patient data, including disease history, baseline characteristics at enrolment and course of disease were analysed in patients with early versus late (=24 months after diagnosis) and no anti-TNF treatment. RESULTS A reduced risk of developing bowel stenosis was found in patients who received early anti-TNF treatment. This association was seen in patients overall and also in the subgroups of CD patients without pre-existing complications (Log-rank test: p<0.001).Furthermore, osteoporosis and anaemia were observed significantly less frequently in patients who received early anti-TNF treatment, compared to either patients who received treatment late (p<0.001 and p=0.046, respectively) or were never (p