Immunosuppressant Combo Safe, Effective for Some Older Crohn’s Patients, Trial Suggests

Immunosuppressant Combo Safe, Effective for Some Older Crohn’s Patients, Trial Suggests
Early treatment with a combination of immunosuppressant medications may be effective and safe for older patients with Crohn’s disease, as much as it is for younger patients, data from a clinical trial suggest. This approach may be considered as a safe alternative for treating some older patients with Crohn's disease, rather than long-term repeated use of steroids. The findings appear in the study “Early combined immunosuppression may be effective and safe in older patients with Crohn’s disease: post hoc analysis of REACT,” which was published in the journal Alimentary Pharmacology and Therapeutics. Combining medications that reduce the activity of the immune system, known as immunosuppressants, has proven successful at controlling or reducing symptoms in young patients with Crohn's disease at high risk of complications. Usually, these regimens combine anti-metabolites (e.g. methotrexate, azathioprine) with anti-TNF alpha biological medications (e.g. adalimumab, brand name Humira). However, in older patients, who can be at higher risk of treatment-related complications, those drug combinations have been avoided because of safety concerns. A major worry with the use of combined immunosuppression in older adults is the risk of serious infections. However, there is not enough scientific evidence to support or reject this concern in this particular patient group. A group of researchers sought to address the question by re-analyzing data from a prior clinical study they had carried out. The trial REACT (NCT01030809) was designed to evaluate the efficacy of a treatment algorithm that encouraged earlier use of immunosuppressive medications versus conventional treatment for patients with Crohn’s disease. Immunosuppressant combination therapy inc
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