Navigation Links
REACT clinical trial supports new approach of accelerated treatment for Crohn's disease
Date:2/19/2014

The final results from an international clinical trial involving nearly 2,000 patients with Crohn's disease support the use of a new management strategy referred to as accelerated step-care as a best practice for the care of active Crohn's disease. The REACT (Randomized Evaluation of an Algorithm for Crohn's Treatment) study, led by Robarts Clinical Trials at Western University (London, Canada) provides valuable new insights for community gastroenterologists which should benefit patients. The results of the study will be presented at the European Crohn's and Colitis Organisation (ECCO) annual congress taking place in Copenhagen, Denmark on February 20-22, 2014.

Crohn's disease is a chronic, potentially debilitating, condition of the gastrointestinal tract which can cause abdominal pain, diarrhea, vomiting, and weight loss among other symptoms. Well over five million people globally are affected by Crohn's disease and ulcerative colitis.

Dr. Brian Feagan, CEO and Senior Scientific Director of Robarts Clinical Trials and a professor in the Division of Gastroenterology at Western's Schulich School of Medicine & Dentistry, says the medical management of Crohn's disease has undergone important changes over the past two decades with the introduction of TNF antagonists such as adalimumab and infliximab. The current treatment approach features sequential and incremental treatment intensification based on symptoms. In contrast, an accelerated step-care approach involves the early introduction of combined immunosuppression in high risk patients, which has been shown to induce and maintain remission, reduce the use of corticosteroids, and heal intestinal ulceration in those who fail conventional treatment.

Subsequent research, performed in both Crohn's disease and rheumatoid arthritis, indicated that TNF antagonists work best when: 1) used in combination with antimetabolites (e.g., azathioprine, methotrexate) and 2) introduced early in the course of the disease. Controlled studies such as CHARM (Crohn's Trial of the Fully Human Antibody Adalimumab for Remission Maintenance) have also demonstrated that TNF antagonist-based regimens can reduce the rate of surgery and hospitalization in comparison to conventional therapy.

"However, adoption of these key concepts by community gastroenterologists has been relatively slow," says Dr. Feagan. "This is primarily because many believe that the safety and efficacy of these agents may not be generalizable to their individual practice, since they were tested in academic centers. The REACT study was designed to address these concerns."

In this cluster-randomized trial, 39 community gastroenterology practices in Canada or Belgium were randomly assigned to a conventional management approach or to an accelerated step-care algorithm that featured early use of combined adalimumab/antimetabolite therapy. Within practices, up to 60 consecutive patients were entered and evaluated for 24 months to determine whether the implementation of an accelerated step-care approach would improve the management of Crohn's disease in comparison to conventional management methods.

Final results from the REACT clinical trial showed the proportion of patients in remission at 12 months was marginally greater in the group assigned to accelerated step-care. However, significant and clinically important reduction in rates for hospitalization, complications and surgeries were observed in practices assigned to early combined immunosuppression up to 24 months.

The study reached several important conclusions:

  • Early introduction of combined therapy in the community may be both feasible and safe
  • Use of this paradigm may be more effective than conventional management for the prevention of diseaserelated complications, surgeries and hospitalizations
  • Reliance on symptoms exclusively to guide therapy may be a sub-optimal management strategy


'/>"/>

Contact: Kathy Wallis
kwallis3@uwo.ca
519-661-2111 x81136
University of Western Ontario
Source:Eurekalert  

Related medicine news :

1. Reactions to HIV drug have autoimmune cause, reports AIDS journal
2. Viewers family background affects how they react to MTV shows 16 and Pregnant, Teen Mom
3. Newly Aggressive Dogs May Be Reacting to Pain
4. Genes May Influence Reactions to Painkillers
5. New anti-inflammatory drugs pinch off reactive oxygen species at the source
6. Study identifies causes for high rates of allergic reactions in children with food allergies
7. Rate of severe reactions higher than thought in young children with food allergies
8. Chronic Pain May Depend on Emotional Reaction to Injury
9. Global platelet reactivity and high risk ACS patients
10. Global platelet reactivity identifies high risk ACS patients
11. Womens Brains React Differently Than Mens to Alcoholism, Study Finds
Post Your Comments:
*Name:
*Comment:
*Email:
Related Image:
REACT clinical trial supports new approach of accelerated treatment for Crohn's disease
(Date:10/13/2017)... ... October 13, 2017 , ... “America On The Brink”: ... “America On The Brink” is the creation of published author, William Nowers. ... As a WWII veteran, he spent thirty years in the Navy. Following ...
(Date:10/12/2017)... ... 12, 2017 , ... The company has developed a suite ... regulatory authorities worldwide. From Children’s to Adults 50+, every formula has been developed ... , These products are also: Gluten Free, Non-GMO, Vegan, Soy Free, Non-Dairy*, ...
(Date:10/12/2017)... (PRWEB) , ... October 12, 2017 , ... ... drug delivery system that we intend to develop to enable prevention of a ... lead to severe hearing loss, especially in pediatric patients. For cisplatin, hearing loss ...
(Date:10/12/2017)... Chapel, FL (PRWEB) , ... October 12, 2017 , ... ... is holding a treadmill relay – Miles by Moonlight to raise money for the ... donating $300 or more. , Teams will work together to keep their treadmills ...
(Date:10/12/2017)... ... 2017 , ... Vohra Chief Medical Officer Dr. Shark Bird, ... nursing facility medical directors and other clinicians at various events in October. His ... many of these conferences we get to educate other physicians, facility nurses, corporate ...
Breaking Medicine News(10 mins):
(Date:10/5/2017)... 2017  In response to the nationwide opioid ... Surgeons (AAOMS) released prescribing recommendations that urge ibuprofen ... as a first-line therapy to manage a patient,s ... Recognizing the value and importance of ... Prescribing: Acute and Postoperative Pain Management" stresses that ...
(Date:10/2/2017)... -- Eli Lilly and Company (NYSE: LLY ) ... of 2017 on Tuesday, October 24, 2017. Lilly will ... the investment community and media to further detail the ... begin at 9 a.m. Eastern time. Investors, media and ... the conference call through a link that will be ...
(Date:9/28/2017)... 2017 Cohen Veterans Bioscience and Early Signal ... wearable and home sensors for real-time monitoring of patients ... a nonprofit organization focused on disruptive health solutions for ... analytical system to record and integrate behavioral, cognitive, physiological ... ...
Breaking Medicine Technology: