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Title: | Endoscopic postoperative recurrence in Crohn’s disease : after curative ileocecal resection with early prophylaxis by anti-TNF, vedolizumab or ustekinumab : a real-world multicentre European study |
Authors: | Yanai, Henit Kagramanova, Anna Knyazev, Oleg Sabino, João Haenen, Shana Mantzaris, Gerassimos J. Mountaki, Katerina Armuzzi, Alessandro Pugliese, Daniela Furfaro, Federica Fiorino, Gionata Drobne, David Kurent, Tina Yassin, Sharif Maharshak, Nitsan Castiglione, Fabiana de Sire, Roberto Nardone, Olga Maria Farkas, Klaudia Molnar, Tamas Krznaric, Zeljko Brinar, Marko Chashkova, Elena Livne Margolin, Moran Kopylov, Uri Bezzio, Cristina Shitrit, AriellaBar-Gi Lukas, Milan Chaparro, María Truyens, Marie Nancey, Stéphane Lobaton, Triana Gisbert, Javier P. Saibeni, Simone Bacsúr, Péter Bossuyt, Peter Schulberg, Julien Hoentjen, Frank Viganò, Chiara Palermo, Andrea Torres, Joana Revés, Joana Karmiris, Konstantinos Velegraki, Magdalini Savarino, Edoardo Markopoulos, Panagiotis Tsironi, Eftychia Ellul, Pierre Suárez, Cristina Calviño Weisshof, Roni Ben-Hur, Dana Naftali, Timna Eriksson, Carl Koutroubakis, Ioannis E. Foteinogiannopoulou, Kalliopi Limdi, Jimmy K. Liu, Eleanor Surís, Gerard Calabrese, Emma Zorzi, Francesca Filip, Rafał Ribaldone, Davide Giuseppe Snir, Yifat Goren, Idan Banai-Eran, Hagar Broytman, Yelena Amir Barak, Hadar Avni-Biron, Irit Ollech, Jacob E. Dotan, Iris Golan, Maya Aharoni |
Keywords: | Inflammatory bowel diseases Crohn's disease Biologicals Endoscopy Gastroenteritis |
Issue Date: | 2022 |
Publisher: | Oxford University Press |
Citation: | Yanai, H., Kagramanova, A., Knyazev, O., Sabino, J., Haenen, S., Mantzaris, G. J., ... & Aharoni Golan, M. (2022). Endoscopic postoperative recurrence in Crohn’s disease after curative ileocecal resection with early prophylaxis by anti-TNF, vedolizumab or ustekinumab: a real-world multicentre European study. Journal of Crohn's and Colitis, 16(12), 1882-1892. |
Abstract: | Background: Endoscopic-post-operative-recurrence [ePOR] in Crohn’s disease [CD] after ileocecal resection [ICR] is a major concern. We aimed to evaluate the effectiveness of early prophylaxis with biologics and to compare anti-tumour necrosis factor [anti-TNF] therapy to vedolizumab [VDZ] and ustekinumab [UST] in a real-world setting. Methods: A retrospective multicentre study of CD-adults after curative ICR on early prophylaxis was undertaken. ePOR was defined as a Rutgeerts score [RS] ≥ i2 or colonic-segmental-SES-CD ≥ 6. Multivariable logistic regression was used to evaluate risk factors, and inverse prob ability treatment weighting [IPTW] was applied to compare the effectiveness between agents. Results: The study included 297 patients (53.9% males, age at diagnosis 24 years [19–32], age at ICR 34 years [26–43], 18.5% smokers, 27.6% biologic-naïve, 65.7% anti-TNF experienced, 28.6% two or more biologics and 17.2% previous surgery). Overall, 224, 39 and 34 patients received anti-TNF, VDZ or UST, respectively. Patients treated with VDZ and UST were more biologic experienced with higher rates of previous surgery. ePOR rates within 1 year were 41.8%. ePOR rates by treatment groups were: anti-TNF 40.2%, VDZ 33% and UST 61.8%. Risk factors for ePOR at 1 year were: past-infliximab (adjusted odds ratio [adj.OR] = 1.73 [95% confidence interval, CI: 1.01–2.97]), past-adalimumab [adj.OR = 2.32 [95% CI: 1.35-4.01] and surgical aspects. After IPTW, the risk of ePOR within 1 year of VDZ vs anti-TNF or UST vs anti-TNF was comparable (OR = 0.55 [95% CI: 0.25–1.19], OR = 1.86 [95% CI: 0.79–4.38]), respectively. Conclusion. Prevention of ePOR within 1 year after surgery was successful in ~60% of patients. Patients treated with VDZ or UST consisted of a more refractory group. After controlling for confounders, no differences in ePOR risk were seen between anti-TNF prophylaxis and other groups. |
URI: | https://www.um.edu.mt/library/oar/handle/123456789/119955 |
Appears in Collections: | Scholarly Works - FacM&SMed |
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