• Posted December 27, 2024

In Kids with Crohn's Disease, TNF Inhibitors Help Prevent Serious Complications, Data Suggests

FRIDAY, Dec. 27, 2024 (HealthDay News) A specific class of anti-inflammatory drugs can help children avoid a debilitating complication of Crohn’s disease.

A new study published recently in the journal Gut shows children with Crohn's who were prescribed anti-TNF (tumor necrosis factor) drugs following their diagnosis had an 82% lower risk of anal fistulas, or tunnels that develop from inside the anus to the skin outside.

These tunnels appear as open draining sores near the anus, and increase a child’s risk of infections or organ damage, researchers said.

About 70% of kids who develop an anal fistula require at least one surgical procedure, researchers said. This frequently involves fitting the child with a colostomy bag.

“If we can prevent these disease complications, that’s way better than trying to address them once they develop, because they’re so hard to treat,” lead researcher Dr. Jeremy Adler, a clinical professor of pediatric gastroenterology with the University of Michigan, said in a news release.

About 40,000 children in the U.S. suffer from Crohn’s disease, a chronic inflammatory disease of the gut that causes diarrhea, cramping and pain.

Of those children, about one in three will develop anal fistulas, researchers said.

For the study, researchers tracked more than 900 children newly diagnosed with Crohn’s.

They found that prescribing anti-TNF drugs like infliximab and adalimumab from the outset significantly decreased a child’s risk of anal fistulas. These drugs block TNF, a substance that causes inflammation.

This was particularly true for children who had already developed large skin tags, ulcers or fissures near their anus. The presence of these lesions quadruples a child’s odds of anal fissures, study results show.

But for those kids, anti-TNF drugs decreased their risk of anal fistulas by 93%, researchers found.

Anti-TNF drugs are pricier than other anti-inflammatory drugs used to treat Crohn’s like azathioprine and methotrexate, researchers said.

However, these results show that anti-TNF drugs might be worth the added cost, if they can help kids avoid anal fistulas that are even more expensive to treat, Adler said.

“For the insurance companies, you prevent the fistulas and all the downstream complications those cost,” Adler said. “For the physician, it shows this is really the more efficacious treatment.”

“For the families, it’s a question of which drug. And this group of medicines is so effective at preventing complications," Adler concluded.

More information

The Cleveland Clinic has more on anal fistulas.

SOURCE: University of Michigan, news release, Dec. 27, 2024