Connecticut Children’s is among the most active in the country for basic, clinical and translational research. Our nationally recognized gastroenterologists lead and collaborate on 32-IRB approved studies including NIH- and privately-funded digestive diseases research projects.
Biologic Agents Provide Relief for Children Newly Diagnosed with Crohn’s Disease
Jeffrey Hyams, MD authored a study in Gastroenterology1, the official journal of the American Gastroenterological Association, children newly diagnosed with Crohn’s disease may benefit from early treatment with the biologic drugs known as anti-TNF-α agents.
“While the use of biologic drugs, such as infliximab or adalimumab, is generally reserved for patients who have failed previous therapy for Crohn’s disease, little is known about outcomes following the earlier use,” Dr. Hyams said. “This new research finds that, in children newly diagnosed with moderate to severe Crohn’s disease, early anti-TNF-α therapy is more effective at achieving remission than the current standard treatment.”
Using data from the RISK Stratification Study, an ongoing, prospective observational research program currently involving 28 pediatric gastroenterology centers in North America, researchers compared the effectiveness of early (within three months after diagnosis) treatment with anti-TNF-α inhibitors, compared with early treatment with immunomodulatory drugs, in attaining clinical remission and facilitating growth in children with Crohn's disease. The current standard of care is corticosteroids followed by the early introduction of immunomodulatory drugs.
At one-year, 85 percent of patients receiving early anti-TNF-α therapy alone were in corticosteroid-free clinical remission, a significantly greater proportion than those treated with either early immunomodulators alone (60 percent) or no early immunotherapy (54 percent). Further, at one-year, no patients in the early anti–TNF-α group had a Pediatric Crohn's Disease Activity Index of greater than 30, compared with 7 percent in the early immunomodulators group and 10 percent in the no early immunotherapy group. Only in the early anti-TNF- α group was normal growth velocity established.
Research funding for this study was provided by the Crohn’s and Colitis Foundation of America.
Active Research Initiatives
Connecticut Children's Gastroenterology division is involved in several other research initiatives:
- In 2012, Dr. Hyams, along with Lee “Ted” Denson, MD, from Cincinnati Children’s Hospital Medical Center, received a $10.4M NIH grant for the Predicting Response to Standardized Pediatric Colitis Therapy (PROTECT) study.
- As the hub of the Pediatric Inflammatory Bowel Disease Collaborative Research Group, a 30-member organization formed in 2002, Connecticut Children’s leads ongoing research on the natural history of more than 1,700 cases of newly diagnosed IBD in children, correlating disease behavior with genetic and immunological parameters.
- Connecticut Children’s is the leader with seven pediatric IBD centers in North America, recruiting patients for a groundbreaking study on risk assessment in children newly diagnosed with Crohn’s disease. This study is funded by the Crohn’s and Colitis Foundation.
- Francisco Sylvester, MD, directs the IBD translational laboratory in the department of immunology at the University of Connecticut School of Medicine. Dr. Sylvester along with Anthony Vella, PhD, and a team of post-doctoral fellows are investigating basic mechanisms underlying the inflammatory process in ulcerative colitis and Crohn’s disease.
- Wael Sayej, MD, is investigating basic mechanisms
of inflammation in eosinophilic esophagitis.