Thirty-eight (84 %) patients were treated with IFX prior to initiating combination therapy, and 7 (16 %) were treated with ADA prior to initiating combination therapy. of IBD-related surgery. Among 462 patients, 181 (39 %) were treated with combination therapy. 12 % of patients treated with combination therapy underwent an IBD-related surgery compared to 18 % of patients treated with monotherapy = 0.091), with no overall difference in time to IBD-related surgery demonstrated (log-rank test, = 0.063). When evaluating the subtypes of Cav1.2 IBD, there was a significant benefit in time to GDC-0084 IBD-related surgery among patients with CD treated with sequentially added combination therapy (HR 0.46, 95 % CI 0.25-0.85) but not UC (HR 0.82, 95 % CI 0.30-2.22). Conclusions The benefits of sequentially added combination therapy seem blunted when evaluating long-term clinical outcomes. This may be due to a decreased effectiveness of sequential combination therapy, a loss of benefit over time, or a differential effect between subtypes of IBD. = 0.572. There was no significant difference between duration of monotherapy with GDC-0084 an immunosuppressive agent (96 weeks, SD 149) and monotherapy with an anti-TNF therapy (102 weeks, SD 120), = 0.798. Table 1 Clinical and demographic characteristics of patients treated with monotherapy and combination therapy strategies = 281)= 181)value= 204)(= 113)0.003?0C16 years GDC-0084 old44 (22 %)39 (35 %)?17C39 years old116 (57 %)65 (58 %)?40 years old and over32 (16 %)6 (5 %)Montreal classification: location of Crohn’s disease0.091?Ileal disease39 (19 %)19 (17 %)?Colonic disease46 (23 %)14 (13 %)?Ileocolonic disease115 (57 %)79 (71 %)?Isolated upper disease1 ( 1 %)0Montreal classification: behavior of Crohn’s disease0.068?Non-structuring?Non-penetrating82 (40 %)30 (27 %)?Structuring63 (31 %)37 (33 %33 %)?Penetrating56 (28 %)40 (36 %)Montreal classification: presence of perianal disease0.229?No perianal disease117 (57 %)55 (48 %)?Perianal disease80 (48 %)56 (49 %)Montreal classification: extent of ulcerative colitis(n = 75)(n = 64)0.444?Ulcerative proctitis5 (7 %)1 (2 %)?Left-sided colitis22 (29 %)20 (32 %)?Pancolitis44 (59 %)40 (63 %) Open in a separate window aCategorical data presented as raw data with (%) bContinuous data presented as means with (SD) cIf Montreal classification data were unknown, patients are not listed in this table Among those patients treated with combination therapy, 154 (85 %) utilized combination therapy with IFX as the biologic agent and 48 (27 %) utilized ADA. Twenty-one (12 %) patients received separate periods of combination therapy utilizing IFX and ADA as an anti-TNF therapy. Of the 181 patients who were treated with combination therapy, 136 (75 %) were initiated on an immunosuppressive agent prior to utilization of a combination therapy strategy. Of these 136 patients, 82 (60 %60 %) were initiated on MP and 54 (40 %) were initiated on AZA. A smaller portion of patients (45 total) were treated with anti-TNF therapy prior to ultimate treatment with a combination therapy regimen. Thirty-eight GDC-0084 (84 %) patients were treated with IFX prior to initiating combination therapy, and 7 (16 %) were treated with ADA prior to initiating combination therapy. Among patients treated with a monotherapy strategy, 30 (11 %) patients were treated with a thiopurine while 251 (89 %) patients were treated with an anti-TNF therapy. For those patients treated with an immunosuppressive agent prior to the initiation of combination therapy, the average duration of therapy with an immunosuppressive agent prior to combination therapy was 170 weeks (SD 190). The average duration of therapy with an anti-TNF therapy prior to combination therapy was 76.6 weeks (SD 107). There was no statistically significant difference in rates of IBD-related surgery when comparing those patients treated with sequentially added combination therapy to those patients treated with monotherapy. Among patients treated with combination therapy, 22 of 181 (12 %) patients underwent an IBD-related surgery compared to 51 of 281 (18 %) patients treated with monotherapy (= 0.091). When the rates of IBD-related surgery were stratified by IBD diagnosis, there was no significant difference in patients with UC (= 1.00) or CD (= 0.142) when comparing the two treatment strategies. When comparing only those patients treated with monotherapy, there was no significant difference between those patients treated with monotherapy with an anti-TNF agent and those patients treated with monotherapy with an immunosup-pressive agent (= 0.084). Although we included data.
