Anti-TNF therapy is associated with a reduction in radiation exposure in patients with Crohn's disease.
Identifieur interne : 001790 ( Main/Exploration ); précédent : 001789; suivant : 001791Anti-TNF therapy is associated with a reduction in radiation exposure in patients with Crohn's disease.
Auteurs : Divya Aggarwal [Royaume-Uni] ; Jimmy K. LimdiSource :
- European journal of gastroenterology & hepatology [ 1473-5687 ] ; 2015.
Descripteurs français
- KwdFr :
- Adalimumab (MeSH), Adulte (MeSH), Adulte d'âge moyen (MeSH), Anti-inflammatoires (usage thérapeutique), Anticorps monoclonaux (usage thérapeutique), Anticorps monoclonaux humanisés (usage thérapeutique), Dose de rayonnement (MeSH), Facteur de nécrose tumorale alpha (antagonistes et inhibiteurs), Femelle (MeSH), Hormones corticosurrénaliennes (usage thérapeutique), Humains (MeSH), Infliximab (MeSH), Intestins (imagerie diagnostique), Jeune adulte (MeSH), Maladie de Crohn (imagerie diagnostique), Maladie de Crohn (traitement médicamenteux), Mâle (MeSH), Pelvis (imagerie diagnostique), Radiographie abdominale (statistiques et données numériques), Sujet âgé (MeSH), Tomodensitométrie (statistiques et données numériques), Études rétrospectives (MeSH).
- MESH :
- antagonistes et inhibiteurs : Facteur de nécrose tumorale alpha.
- imagerie diagnostique : Intestins, Maladie de Crohn, Pelvis.
- statistiques et données numériques : Radiographie abdominale, Tomodensitométrie.
- traitement médicamenteux : Maladie de Crohn.
- usage thérapeutique : Anti-inflammatoires, Anticorps monoclonaux, Anticorps monoclonaux humanisés, Hormones corticosurrénaliennes.
- Adalimumab, Adulte, Adulte d'âge moyen, Dose de rayonnement, Femelle, Humains, Infliximab, Jeune adulte, Mâle, Sujet âgé, Études rétrospectives.
English descriptors
- KwdEn :
- Adalimumab (MeSH), Adrenal Cortex Hormones (therapeutic use), Adult (MeSH), Aged (MeSH), Anti-Inflammatory Agents (therapeutic use), Antibodies, Monoclonal (therapeutic use), Antibodies, Monoclonal, Humanized (therapeutic use), Crohn Disease (diagnostic imaging), Crohn Disease (drug therapy), Female (MeSH), Humans (MeSH), Infliximab (MeSH), Intestines (diagnostic imaging), Male (MeSH), Middle Aged (MeSH), Pelvis (diagnostic imaging), Radiation Dosage (MeSH), Radiography, Abdominal (statistics & numerical data), Retrospective Studies (MeSH), Tomography, X-Ray Computed (statistics & numerical data), Tumor Necrosis Factor-alpha (antagonists & inhibitors), Young Adult (MeSH).
- MESH :
- chemical , antagonists & inhibitors : Tumor Necrosis Factor-alpha.
- chemical , therapeutic use : Adrenal Cortex Hormones, Anti-Inflammatory Agents, Antibodies, Monoclonal, Antibodies, Monoclonal, Humanized.
- chemical : Adalimumab, Infliximab.
- diagnostic imaging : Crohn Disease, Intestines, Pelvis.
- drug therapy : Crohn Disease.
- statistics & numerical data : Radiography, Abdominal, Tomography, X-Ray Computed.
- Adult, Aged, Female, Humans, Male, Middle Aged, Radiation Dosage, Retrospective Studies, Young Adult.
Abstract
OBJECTIVE
Patients with Crohn's disease (CD) are often exposed to ionizing diagnostic radiation with inherent risks from protracted exposure. Meanwhile, bolder definitions of disease control have changed treatment paradigms, with earlier introduction of biological therapy in many. Our aim was to compare the effective radiation dose a year before and 1 and 3 years after initiating anti-tumor necrosis factor (anti-TNF) or corticosteroid therapy.
MATERIALS AND METHODS
We performed a retrospective review of CD patients treated with anti-TNF (infliximab or adalimumab) or corticosteroids at our institution from 2005 to 2012.
RESULTS
We analyzed 170 patients with CD (114 treated with anti-TNF and 56 treated with corticosteroid). Between the year preceding and the year following therapy, a significant decrease in the mean number of radiology studies (-2.0 vs. -0.2, P=0.001) and the cumulative radiation dose (-3.1 vs. +0.3 mSv, P=0.01) was seen in the anti-TNF group when compared with the steroid group. Between the year preceding therapy and 3 years following therapy, a significant increase in the mean number of radiology studies (+2.3 vs. +0.3, P=0.003) and the cumulative radiation dose (+6.8 vs. +1.3 mSv, P=0.003) was seen in the steroid group when compared with the anti-TNF group. After adjusting for predictors of high diagnostic radiation exposure, the anti-TNF-treated group had a decrease in the number of imaging studies by 2 within a year of therapy (P<0.001).
CONCLUSION
Anti-TNF but not corticosteroid therapy is associated with a significant reduction in diagnostic radiation exposure a year after treatment, which persisted after 3 years.
DOI: 10.1097/MEG.0000000000000222
PubMed: 25341058
Affiliations:
Links toward previous steps (curation, corpus...)
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Limdi</name></author></analytic><series><title level="j">European journal of gastroenterology & hepatology</title><idno type="eISSN">1473-5687</idno><imprint><date when="2015" type="published">2015</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adalimumab (MeSH)</term><term>Adrenal Cortex Hormones (therapeutic use)</term><term>Adult (MeSH)</term><term>Aged (MeSH)</term><term>Anti-Inflammatory Agents (therapeutic use)</term><term>Antibodies, Monoclonal (therapeutic use)</term><term>Antibodies, Monoclonal, Humanized (therapeutic use)</term><term>Crohn Disease (diagnostic imaging)</term><term>Crohn Disease (drug therapy)</term><term>Female (MeSH)</term><term>Humans (MeSH)</term><term>Infliximab (MeSH)</term><term>Intestines (diagnostic imaging)</term><term>Male (MeSH)</term><term>Middle Aged (MeSH)</term><term>Pelvis (diagnostic imaging)</term><term>Radiation Dosage (MeSH)</term><term>Radiography, Abdominal (statistics & numerical data)</term><term>Retrospective Studies (MeSH)</term><term>Tomography, X-Ray Computed (statistics & numerical data)</term><term>Tumor Necrosis Factor-alpha (antagonists & inhibitors)</term><term>Young Adult (MeSH)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adalimumab (MeSH)</term><term>Adulte (MeSH)</term><term>Adulte d'âge moyen (MeSH)</term><term>Anti-inflammatoires (usage thérapeutique)</term><term>Anticorps monoclonaux (usage thérapeutique)</term><term>Anticorps monoclonaux humanisés (usage thérapeutique)</term><term>Dose de rayonnement (MeSH)</term><term>Facteur de nécrose tumorale alpha (antagonistes et inhibiteurs)</term><term>Femelle (MeSH)</term><term>Hormones corticosurrénaliennes (usage thérapeutique)</term><term>Humains (MeSH)</term><term>Infliximab (MeSH)</term><term>Intestins (imagerie diagnostique)</term><term>Jeune adulte (MeSH)</term><term>Maladie de Crohn (imagerie diagnostique)</term><term>Maladie de Crohn (traitement médicamenteux)</term><term>Mâle (MeSH)</term><term>Pelvis (imagerie diagnostique)</term><term>Radiographie abdominale (statistiques et données numériques)</term><term>Sujet âgé (MeSH)</term><term>Tomodensitométrie (statistiques et données numériques)</term><term>Études rétrospectives (MeSH)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="antagonists & inhibitors" xml:lang="en"><term>Tumor Necrosis Factor-alpha</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Adrenal Cortex Hormones</term><term>Anti-Inflammatory Agents</term><term>Antibodies, Monoclonal</term><term>Antibodies, Monoclonal, Humanized</term></keywords><keywords scheme="MESH" type="chemical" xml:lang="en"><term>Adalimumab</term><term>Infliximab</term></keywords><keywords scheme="MESH" qualifier="antagonistes et inhibiteurs" xml:lang="fr"><term>Facteur de nécrose tumorale alpha</term></keywords><keywords scheme="MESH" qualifier="diagnostic imaging" xml:lang="en"><term>Crohn Disease</term><term>Intestines</term><term>Pelvis</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Crohn Disease</term></keywords><keywords scheme="MESH" qualifier="imagerie diagnostique" xml:lang="fr"><term>Intestins</term><term>Maladie de Crohn</term><term>Pelvis</term></keywords><keywords scheme="MESH" qualifier="statistics & numerical data" xml:lang="en"><term>Radiography, Abdominal</term><term>Tomography, X-Ray Computed</term></keywords><keywords scheme="MESH" qualifier="statistiques et données numériques" xml:lang="fr"><term>Radiographie abdominale</term><term>Tomodensitométrie</term></keywords><keywords scheme="MESH" qualifier="traitement médicamenteux" xml:lang="fr"><term>Maladie de Crohn</term></keywords><keywords scheme="MESH" qualifier="usage thérapeutique" xml:lang="fr"><term>Anti-inflammatoires</term><term>Anticorps monoclonaux</term><term>Anticorps monoclonaux humanisés</term><term>Hormones corticosurrénaliennes</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Aged</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Radiation Dosage</term><term>Retrospective Studies</term><term>Young Adult</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adalimumab</term><term>Adulte</term><term>Adulte d'âge moyen</term><term>Dose de rayonnement</term><term>Femelle</term><term>Humains</term><term>Infliximab</term><term>Jeune adulte</term><term>Mâle</term><term>Sujet âgé</term><term>Études rétrospectives</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>OBJECTIVE</b></p><p>Patients with Crohn's disease (CD) are often exposed to ionizing diagnostic radiation with inherent risks from protracted exposure. Meanwhile, bolder definitions of disease control have changed treatment paradigms, with earlier introduction of biological therapy in many. Our aim was to compare the effective radiation dose a year before and 1 and 3 years after initiating anti-tumor necrosis factor (anti-TNF) or corticosteroid therapy.</p></div><div type="abstract" xml:lang="en"><p><b>MATERIALS AND METHODS</b></p><p>We performed a retrospective review of CD patients treated with anti-TNF (infliximab or adalimumab) or corticosteroids at our institution from 2005 to 2012.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>We analyzed 170 patients with CD (114 treated with anti-TNF and 56 treated with corticosteroid). Between the year preceding and the year following therapy, a significant decrease in the mean number of radiology studies (-2.0 vs. -0.2, P=0.001) and the cumulative radiation dose (-3.1 vs. +0.3 mSv, P=0.01) was seen in the anti-TNF group when compared with the steroid group. Between the year preceding therapy and 3 years following therapy, a significant increase in the mean number of radiology studies (+2.3 vs. +0.3, P=0.003) and the cumulative radiation dose (+6.8 vs. +1.3 mSv, P=0.003) was seen in the steroid group when compared with the anti-TNF group. After adjusting for predictors of high diagnostic radiation exposure, the anti-TNF-treated group had a decrease in the number of imaging studies by 2 within a year of therapy (P<0.001).</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSION</b></p><p>Anti-TNF but not corticosteroid therapy is associated with a significant reduction in diagnostic radiation exposure a year after treatment, which persisted after 3 years.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">25341058</PMID><DateCompleted><Year>2015</Year><Month>07</Month><Day>29</Day></DateCompleted><DateRevised><Year>2018</Year><Month>12</Month><Day>02</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Electronic">1473-5687</ISSN><JournalIssue CitedMedium="Internet"><Volume>27</Volume><Issue>1</Issue><PubDate><Year>2015</Year><Month>Jan</Month></PubDate></JournalIssue><Title>European journal of gastroenterology & hepatology</Title><ISOAbbreviation>Eur J Gastroenterol Hepatol</ISOAbbreviation></Journal><ArticleTitle>Anti-TNF therapy is associated with a reduction in radiation exposure in patients with Crohn's disease.</ArticleTitle><Pagination><MedlinePgn>13-9</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1097/MEG.0000000000000222</ELocationID><Abstract><AbstractText Label="OBJECTIVE" NlmCategory="OBJECTIVE">Patients with Crohn's disease (CD) are often exposed to ionizing diagnostic radiation with inherent risks from protracted exposure. Meanwhile, bolder definitions of disease control have changed treatment paradigms, with earlier introduction of biological therapy in many. Our aim was to compare the effective radiation dose a year before and 1 and 3 years after initiating anti-tumor necrosis factor (anti-TNF) or corticosteroid therapy.</AbstractText><AbstractText Label="MATERIALS AND METHODS" NlmCategory="METHODS">We performed a retrospective review of CD patients treated with anti-TNF (infliximab or adalimumab) or corticosteroids at our institution from 2005 to 2012.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">We analyzed 170 patients with CD (114 treated with anti-TNF and 56 treated with corticosteroid). Between the year preceding and the year following therapy, a significant decrease in the mean number of radiology studies (-2.0 vs. -0.2, P=0.001) and the cumulative radiation dose (-3.1 vs. +0.3 mSv, P=0.01) was seen in the anti-TNF group when compared with the steroid group. Between the year preceding therapy and 3 years following therapy, a significant increase in the mean number of radiology studies (+2.3 vs. +0.3, P=0.003) and the cumulative radiation dose (+6.8 vs. +1.3 mSv, P=0.003) was seen in the steroid group when compared with the anti-TNF group. After adjusting for predictors of high diagnostic radiation exposure, the anti-TNF-treated group had a decrease in the number of imaging studies by 2 within a year of therapy (P<0.001).</AbstractText><AbstractText Label="CONCLUSION" NlmCategory="CONCLUSIONS">Anti-TNF but not corticosteroid therapy is associated with a significant reduction in diagnostic radiation exposure a year after treatment, which persisted after 3 years.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Aggarwal</LastName><ForeName>Divya</ForeName><Initials>D</Initials><AffiliationInfo><Affiliation>Department of Gastroenterology, The Pennine Acute Hospitals NHS Trust, Manchester, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Limdi</LastName><ForeName>Jimmy K</ForeName><Initials>JK</Initials></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D003160">Comparative Study</PublicationType><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>Eur J Gastroenterol Hepatol</MedlineTA><NlmUniqueID>9000874</NlmUniqueID><ISSNLinking>0954-691X</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D000305">Adrenal Cortex Hormones</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D000893">Anti-Inflammatory Agents</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D000911">Antibodies, Monoclonal</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D061067">Antibodies, Monoclonal, Humanized</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D014409">Tumor Necrosis Factor-alpha</NameOfSubstance></Chemical><Chemical><RegistryNumber>B72HH48FLU</RegistryNumber><NameOfSubstance 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MajorTopicYN="N">Anti-Inflammatory Agents</DescriptorName><QualifierName UI="Q000627" MajorTopicYN="Y">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D000911" MajorTopicYN="N">Antibodies, Monoclonal</DescriptorName><QualifierName UI="Q000627" MajorTopicYN="Y">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D061067" MajorTopicYN="N">Antibodies, Monoclonal, Humanized</DescriptorName><QualifierName UI="Q000627" MajorTopicYN="Y">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D003424" MajorTopicYN="N">Crohn Disease</DescriptorName><QualifierName UI="Q000000981" MajorTopicYN="Y">diagnostic imaging</QualifierName><QualifierName UI="Q000188" MajorTopicYN="Y">drug therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000069285" MajorTopicYN="N">Infliximab</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D007422" MajorTopicYN="N">Intestines</DescriptorName><QualifierName UI="Q000000981" MajorTopicYN="N">diagnostic imaging</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D010388" MajorTopicYN="N">Pelvis</DescriptorName><QualifierName UI="Q000000981" MajorTopicYN="N">diagnostic imaging</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D011829" MajorTopicYN="Y">Radiation Dosage</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011860" MajorTopicYN="N">Radiography, Abdominal</DescriptorName><QualifierName UI="Q000706" MajorTopicYN="N">statistics & numerical data</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D012189" MajorTopicYN="N">Retrospective Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D014057" MajorTopicYN="N">Tomography, X-Ray Computed</DescriptorName><QualifierName UI="Q000706" MajorTopicYN="N">statistics & numerical data</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D014409" MajorTopicYN="N">Tumor Necrosis Factor-alpha</DescriptorName><QualifierName UI="Q000037" MajorTopicYN="Y">antagonists & inhibitors</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D055815" MajorTopicYN="N">Young Adult</DescriptorName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="entrez"><Year>2014</Year><Month>10</Month><Day>24</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2014</Year><Month>10</Month><Day>24</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2015</Year><Month>7</Month><Day>30</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">25341058</ArticleId><ArticleId IdType="doi">10.1097/MEG.0000000000000222</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>Royaume-Uni</li></country><region><li>Angleterre</li><li>Grand Manchester</li></region><settlement><li>Manchester</li></settlement></list><tree><noCountry><name sortKey="Limdi, Jimmy K" sort="Limdi, Jimmy K" uniqKey="Limdi J" first="Jimmy K" last="Limdi">Jimmy K. Limdi</name></noCountry><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Aggarwal, Divya" sort="Aggarwal, Divya" uniqKey="Aggarwal D" first="Divya" last="Aggarwal">Divya Aggarwal</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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