BD Constant et al. American Journal of Gastroenterology Publish Ahead of Print, July 1, 2026. | DOI: 10.14309/ajg.0000000000004104. The Safety and Effectiveness of Early Anti-tumor-necrosis-factor Therapy for Penetrating Crohn’s Disease Complications in Children

Methods: This was a multicenter retrospective study examining the safety of anti-TNF therapy in children (n=203) with Crohn’s disease (CD) who developed internally penetrating complications (IPCs; abscesses and inflammatory masses). The exposure timeframe was anti-TNF administration within 30 days of IPC diagnosis.

Key findings:

• In Cox analyses, early anti-TNF was not linked to infectious serious adverse events (iSAE), noninfectious CD-related SAE, or surgeries, but was associated with increased combined clinical-biochemical-corticosteroid-free remission (hazard ratio 1.65).
• Surgical risk differed by percutaneous drainage (PD) status: patients receiving early anti-TNF and PD had lower risk versus PD alone (event-free survival 58% vs 15%, log-rank P = 0.04).

My take: For many years, my practice has been to use early anti-TNF even in patients with internally penetrating complications. This study confirms that anti-TNF therapy may be beneficial in this setting.

Related blog posts:

• Early Postoperative Anti-TNF Therapy
• Safety of Preoperative Tumor Necrosis Factor  Inhibitor Exposure in Patients With Inflammatory Bowel Disease Undergoing Intra-abdominal Surgery
• Is There An Increased Risk of Infections with Anti-TNF Therapy?
• Efficacy of Anti-TNF Agents for Internal Fistulas and Study of Antibiotics and Development of IBD
• Is It RISKy Not To Use Anti-TNF Therapy for Pediatric Crohn’s Disease?
• CCFA 2023 (Atlanta) Part 5
• Surgery Compared to Biologic Therapy for Crohn’s Disease
• Do Setons Improve Outcomes in Anti-TNF Treatment for Fistulas?

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