Table 2.
Comparison between early and late initiators of anti-TNF therapy for colectomy, hospitalization, and clinical secondary loss of response requiring dose escalation during maintenance infliximab or adalimumab.
| Early initiation of anti-TNF∗ | Late initiation of anti-TNF | p value | |
|---|---|---|---|
| Colectomy outcomes | |||
| Colectomy (n, %) | 10 (17.5) | 5 (8.6) | 0.16 |
| Colectomy rate (per 100 patient-years, 95% CI) | 6.0 [2.9–11.0] | 2.7 [0.9–6.2] | 0.13 |
| Median time to colectomy after anti-TNF (weeks, IQR) | 49.1 (35.3–125.6) | 119.0 (86.9–197.0) | 0.61 |
|
| |||
| Indications for colectomy | |||
| Medically refractory disease | 8 (80.0) | 3 (60.0) | 0.34 |
| Disease-related complication | 2 (20.0) | 1 (20.0) | |
| Dysplasia or colorectal malignancy | 0 (0) | 1 (20.0) | |
|
| |||
| Surgical urgency (%) | |||
| Elective surgery | 5 (50.0) | 4 (80.0) | 0.26 |
| Emergent surgery | 5 (50.0) | 1 (20.0) | |
|
| |||
| Clinical hospitalization outcomes | |||
| UC-related hospitalization (n, %) | 25 (43.9) | 16 (27.6) | 0.07 |
| UC-related hospitalization rate (per 100 patient-years, 95% CI) | 26.8 [19.6–35.9] | 13.9 [9.1–20.4] | 0.01 |
| Median time to first UC-related hospitalization (weeks, IQR) | 25.6 (8.6–68.7) | 52.5 (28.9–96.4) | 0.08 |
|
| |||
| Clinical secondary loss of response outcomes | |||
| Secondary loss of response requiring dose escalation (n, %) | 28 (49.1) | 34 (58.6) | 0.31 |
| Secondary loss of response rate (per 100 patient-years, 95% CI) | 16.7 [11.1–24.1] | 18.2 [12.6–25.4] | 0.74 |
| Median time to dose escalation (weeks, IQR) | 43.6 (23.6–70.9) | 48.2 (23.4–109.9) | 0.80 |
∗Early anti-TNF initiation defined as receiving first induction dose of infliximab or adalimumab within three years of diagnosis.