Crohn Disease Treatment Reduces Need for Surgery in Some

Prolonged use of azathioprine (AZA) treatment is associated with a reduced need for Crohn disease (CD)-related surgery in patients with early CD, according to a recent study.

For their study, the researchers evaluated 190 patients with early CD, defined as a disease duration of 18 months or more and no prior use of disease-modifying agents, according to the Paris definition. Median follow-up lasted 57 months.
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The primary outcome was the proportion of CD-related intestinal surgery. Potential predictive factors of CD progression were identified via Cox regression analysis.

Over the course of follow-up, 31 patients had undergone abdominal surgeries, 48 had been hospitalized, and 68 had experienced clinical flares. The cumulative rate of remaining free of CD-related bowel surgery was 0.65, compared with a rate of 0.59 for remaining free hospitalization, and 0.39 for remaining free of flare at 5 years of AZA treatment.

Prior bowel resection, smoking, and hemoglobin levels below 110 g/L at the time of initiation of AZA were all independent predictors of CD-related surgeries. However, an AZA treatment duration of 36 month or more was found to be associated with reduced CD-related surgeries.

“Prior bowel resection, smoking and hemoglobin [below 110 g/L] at the time of initiation of AZA were risk factors associated with intestinal surgery in patients with early CD,” the researchers concluded. “However, prolonged use [(36 months or more)] of AZA was associated with a more favorable disease course of early CD.”

—Christina Vogt

Reference:

Qiu Y, Chen B, Feng R, et al. Prolonged azathioprine treatment reduces the need for surgery in early Crohn's disease [Published online September 22, 2017]. J Gastroenterol Hepatol. doi:10.1111/jgh.14000.