Similar Clinical and Surgical Outcomes Achieved with Early Compared to Late Anti-TNF Induction in Mild-to-Moderate Ulcerative Colitis: A Retrospective Cohort Study

Table 2

Comparison between early and late initiators of anti-TNF therapy for colectomy, hospitalization, and clinical secondary loss of response requiring dose escalation during maintenance infliximab or adalimumab.

	Early initiation of anti-TNF	Late initiation of anti-TNF	value
Colectomy outcomes
Colectomy (, %)	10 (17.5)	5 (8.6)	0.16
Colectomy rate (per 100 patient-years, 95% CI)	6.0 [2.9–11.0]	2.7 [0.9–6.2]	0.13
Median time to colectomy after anti-TNF (weeks, IQR)	49.1 (35.3–125.6)	119.0 (86.9–197.0)	0.61
Indications for colectomy
Medically refractory disease	8 (80.0)	3 (60.0)	0.34
Disease-related complication	2 (20.0)	1 (20.0)
Dysplasia or colorectal malignancy	0 (0)	1 (20.0)
Surgical urgency (%)
Elective surgery	5 (50.0)	4 (80.0)	0.26
Emergent surgery	5 (50.0)	1 (20.0)
Clinical hospitalization outcomes
UC-related hospitalization (, %)	25 (43.9)	16 (27.6)	0.07
UC-related hospitalization rate (per 100 patient-years, 95% CI)	26.8 [19.6–35.9]	13.9 [9.1–20.4]	0.01
Median time to first UC-related hospitalization (weeks, IQR)	25.6 (8.6–68.7)	52.5 (28.9–96.4)	0.08
Clinical secondary loss of response outcomes
Secondary loss of response requiring dose escalation (, %)	28 (49.1)	34 (58.6)	0.31
Secondary loss of response rate (per 100 patient-years, 95% CI)	16.7 [11.1–24.1]	18.2 [12.6–25.4]	0.74
Median time to dose escalation (weeks, IQR)	43.6 (23.6–70.9)	48.2 (23.4–109.9)	0.80

Early anti-TNF initiation defined as receiving first induction dose of infliximab or adalimumab within three years of diagnosis.