{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T13:06:05Z","timestamp":1793279165516,"version":"4.5.0"},"reference-count":37,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2023,11,27]],"date-time":"2023-11-27T00:00:00Z","timestamp":1701043200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"European Union\u2019s Horizon","award":["668023"],"award-info":[{"award-number":["668023"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,5,31]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background and Aims<\/jats:title>\n                  <jats:p>Treatment guidelines for paediatric Crohn\u2019s disease [CD] suggest early use of anti-tumour necrosis factor alpha [anti-TNF\u03b1] in high-risk individuals. The aim is to evaluate the effect of early anti-TNF in a real-world cohort.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Children with newly diagnosed CD were prospectively recruited at 28 participating sites of the international observational PIBD-SETQuality study. Outcomes were compared at 3 months, 1 and 2 years between patients receiving early anti-TNF [&amp;lt;90 days after diagnosis] and those not receiving early anti-TNF. Outcomes included sustained steroid-free remission [SSFR] without treatment intensification [specified as SSFR*] and sustained steroid-free mild\/inactive disease without treatment intensification [specified as SSFMI*]. Penalised logistic regression model-based standardisation was applied to estimate the relative risks [RR] of early therapy on outcomes. RRs were estimated for high-risk and low-risk patients, based on presence of predictors of poor outcome [POPOs] and disease activity at diagnosis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>In total, 331 children (median age 13.9 years [IQR 12.2\u201315.3]) were enrolled, with 135 [41%] receiving early anti-TNF. At 1 year, patients on early anti-TNF had higher rates of SSFR* [30% vs 14%, p\u2005&amp;lt;0.001] and SSFMI* [69% vs 33%, p\u2005&amp;lt;0.001], with RRs of 2.95 [95% CI 1.63-5.36] and 4.67 [95% CI 2.46-8.87], respectively. At 1 year, the RRs for SSFMI* were higher, and statistically significant in high-risk patients, i.e. those with moderate\/severe disease compared with mild\/inactive disease at diagnosis (5.50 [95% CI 2.51-12.05] vs 2.91 [95% CI 0.92-9.11]), and those with any POPO compared with no POPO (5.05 [95% CI 2.45-10.43] vs 3.41 [95% CI 0.54-21.7]).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>In this cohort of children with newly-diagnosed CD, early anti-TNF demonstrated superior effectiveness in high-risk patients.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ecco-jcc\/jjad197","type":"journal-article","created":{"date-parts":[[2023,11,25]],"date-time":"2023-11-25T14:24:25Z","timestamp":1700922265000},"page":"738-750","source":"Crossref","is-referenced-by-count":17,"title":["Improved Clinical Outcomes With Early Anti-Tumour Necrosis Factor Alpha Therapy in Children With Newly Diagnosed Crohn\u2019s Disease: Real-world Data from the International Prospective PIBD-SETQuality Inception Cohort Study"],"prefix":"10.1093","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7736-0704","authenticated-orcid":false,"given":"Renz C W","family":"Klomberg","sequence":"first","affiliation":[{"name":"Department of Pediatric Gastroenterology, Sophia Children\u2019s Hospital , Rotterdam , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hella C","family":"van der Wal","sequence":"additional","affiliation":[{"name":"Department of Pediatric Gastroenterology, Sophia Children\u2019s Hospital , Rotterdam , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martine A","family":"Aardoom","sequence":"additional","affiliation":[{"name":"Department of Pediatric Gastroenterology, Sophia Children\u2019s Hospital , Rotterdam , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Polychronis","family":"Kemos","sequence":"additional","affiliation":[{"name":"Pediatric Gastroenterology, Centre for Immunobiology, Blizard Institute, Barts and the London School of Medicine, Queen Mary University of London , London , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9397-0900","authenticated-orcid":false,"given":"Dimitris","family":"Rizopoulos","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Erasmus Medical Centre , Rotterdam , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank M","family":"Ruemmele","sequence":"additional","affiliation":[{"name":"Department of Pediatric Gastroenterology, Universit\u00e9 Paris Descartes, Sorbonne Paris Cit\u00e9, H\u00f4pital Necker Enfants Malades , Paris , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3405-1995","authenticated-orcid":false,"given":"Mohammed","family":"Charrout","sequence":"additional","affiliation":[{"name":"Delft Bioinformatics Laboratory, Delft University of Technology , Delft , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hankje C","family":"Escher","sequence":"additional","affiliation":[{"name":"Department of Pediatric Gastroenterology, Sophia Children\u2019s Hospital , Rotterdam , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1519-6435","authenticated-orcid":false,"given":"Nicholas M","family":"Croft","sequence":"additional","affiliation":[{"name":"Pediatric Gastroenterology, Centre for Immunobiology, Blizard Institute, Barts and the London School of Medicine, Queen Mary University of London , London , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lissy","family":"de Ridder","sequence":"additional","affiliation":[{"name":"Department of Pediatric Gastroenterology, Sophia Children\u2019s Hospital , Rotterdam , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"PIBD-SETQuality collaborative group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivan D","family":"Milovanovich","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James J","family":"Ashton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Henderson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oren","family":"Ledder","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim G J","family":"de 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