Patients with inflammatory bowel disease who received infliximab and immunomodulator dual experienced 50% fewer hospitalizations and related surgeries more rapidly than those treated with monotherapy regimens in a recent study.
Researchers conducted a retrospective, observational study of 20,474 veterans (mean age, 60.9 years; 93.9% men) with inflammatory bowel disease (IBD) at 176 VA facilities in the United States from October 2001 through September 2009. Diagnoses included patients with ulcerative colitis (n=12,432) and Crohn’s disease (n=8,042). Primary outcomes were 1-year rates for hospitalizations and IBD-related surgeries.
Patients were prescribed immunomodulator (n=1.3%), infliximab (n=0.17%) or dual therapy (n=1.5%). When adjusted for diagnosis, smoking status and other variables, patients on immunomodulator therapy achieved a 50% reduction in hospitalizations after 9.2 months (P<.0001), while those receiving infliximab reached the same threshold at 8 months (P<.0001). Patients assigned dual therapy, however, received a similar benefit at 7.7 months (P=.02).
During the first year after therapy initiation, researchers observed 276 IBD-related surgeries. Among patients who received infliximab for 7 months, a 50% relative reduction in related surgeries occurred; 5 months of dual therapy resulted in a similar reduction. Compared with receiving no drugs, relative rate reductions in surgery and hospitalizations at 9 months were 92% and 73.1%, respectively, among patients assigned dual therapy.
“Dual therapy with infliximab and an immunomodulator for less than 8 months is associated with significant reductions in hospitalization and surgery within 1 year of the start of therapy,” the researchers concluded. “These findings indicate that patients with IBD are more likely to benefit if dual therapy is initiated earlier in their first year of therapy.”
Disclosure: The researchers report no relevant financial disclosures.