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. 2021 Sep 26;10(19):4402.
doi: 10.3390/jcm10194402.

Impact of Biological Agents on Postsurgical Complications in Inflammatory Bowel Disease: A Multicentre Study of Geteccu

María José García  1 , Montserrat Rivero  1 , José Miranda-Bautista  2 , Iria Bastón-Rey  3 , Francisco Mesonero  4 , Eduardo Leo-Carnerero  5 , Diego Casas-Deza  6 , Carmen Cagigas Fernández  7 , Albert Martin-Cardona  8 , Ismael El Hajra  9 , Nerea Hernández-Aretxabaleta  10 , Isabel Pérez-Martínez  11 , Esteban Fuentes-Valenzuela  12 , Nuria Jiménez  13 , Cristina Rubín de Célix  14 , Ana Gutiérrez  15 , Cristina Suárez Ferrer  16 , José María Huguet  17 , Agnes Fernández-Clotet  18 , María González-Vivó  19 , Blanca Del Val  20 , Jesús Castro-Poceiro  21 , Luigi Melcarne  22 , Carmen Dueñas  23 , Marta Izquierdo  24 , David Monfort  25 , Abdel Bouhmidi  26 , Patricia Ramírez De la Piscina  27 , Eva Romero  28 , Gema Molina  29 , Jaime Zorrilla  30 , Cristina Calvino-Suárez  3 , Eugenia Sánchez  4 , Andrea Nuñez  5 , Olivia Sierra  6 , Beatriz Castro  1 , Yamile Zabana  8 , Irene González-Partida  9 , Saioa De la Maza  10 , Andrés Castaño  11 , Rodrigo Nájera-Muñoz  12 , Luis Sánchez-Guillén  31 , Micaela Riat Castro  14 , José Luis Rueda  16 , José Manuel Benítez  32 , Pedro Delgado-Guillena  33 , Carlos Tardillo  34 , Elena Peña  35 , Santiago Frago-Larramona  36 , María Carmen Rodríguez-Grau  37 , Rocío Plaza  38 , Pablo Pérez-Galindo  39 , Jesús Martínez-Cadilla  40 , Luis Menchén  2 , Manuel Barreiro-De Acosta  3 , Rubén Sánchez-Aldehuelo  4 , María Dolores De la Cruz  5 , Luis Javier Lamuela  6 , Ignacio Marín  2 , Laura Nieto-García  3 , Antonio López-San Román  4 , José Manuel Herrera  5 , María Chaparro  14 , Javier P Gisbert  14 , On Behalf Of The Young Group Of Geteccu
Affiliations

Impact of Biological Agents on Postsurgical Complications in Inflammatory Bowel Disease: A Multicentre Study of Geteccu

María José García et al. J Clin Med. .

Abstract

Background: The impact of biologics on the risk of postoperative complications (PC) in inflammatory bowel disease (IBD) is still an ongoing debate. This lack of evidence is more relevant for ustekinumab and vedolizumab.

Aims: To evaluate the impact of biologics on the risk of PC.

Methods: A retrospective study was performed in 37 centres. Patients treated with biologics within 12 weeks before surgery were considered "exposed". The impact of the exposure on the risk of 30-day PC and the risk of infections was assessed by logistic regression and propensity score-matched analysis.

Results: A total of 1535 surgeries were performed on 1370 patients. Of them, 711 surgeries were conducted in the exposed cohort (584 anti-TNF, 58 vedolizumab and 69 ustekinumab). In the multivariate analysis, male gender (OR: 1.5; 95% CI: 1.2-2.0), urgent surgery (OR: 1.6; 95% CI: 1.2-2.2), laparotomy approach (OR: 1.5; 95% CI: 1.1-1.9) and severe anaemia (OR: 1.8; 95% CI: 1.3-2.6) had higher risk of PC, while academic hospitals had significantly lower risk. Exposure to biologics (either anti-TNF, vedolizumab or ustekinumab) did not increase the risk of PC (OR: 1.2; 95% CI: 0.97-1.58), although it could be a risk factor for postoperative infections (OR 1.5; 95% CI: 1.03-2.27).

Conclusions: Preoperative administration of biologics does not seem to be a risk factor for overall PC, although it may be so for postoperative infections.

Keywords: Crohn’s disease; anti-TNF; inflammatory bowel disease; postoperative complications; preoperative therapy; surgery; ulcerative colitis; ustekinumab; vedolizumab.

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Conflict of interest statement

María José García has received financial support for travelling and educational activities from MSD, Janssen, Abbvie, Takeda and Ferring. Montserrat Rivero has served as a speaker and advisory member for Abbvie, MSD and Janssen. Manuel Barreiro-De Acosta has served as a speaker, consultant and advisory member for or has received research funding from MSD, AbbVie, Janssen, Kern Pharma, Celltrion, Takeda, Gillead, Celgene, Pfizer, Sandoz, Biogen, Fresenius, Ferring, Faes Farma, Dr. Falk Pharma, Chiesi, Gebro Pharma, Adacyte and Vifor Pharma. Eduardo Leo-Carnerero has served as speaker for and has received research funding from Abbvie, Takeda, Janssen, Ferring and Pfizer. Luis Menchén has served as a speaker or has received research or education funding from MSD, Abbvie, Pfizer, Takeda, Janssen, Ferring, Dr. Falk Pharma, Tillotts Pharma, General Electric, Fresenius, Sandoz and Medtronic. Diego Casas-Deza has received financial support for travelling and educational activities from MSD, Janssen, Ferring, Tillots, Takeda and Abbvie. Albert Martin-Cardona has received financial support for travelling and educational activities from Abbvie, Biogen, Ferring, Jannsen, MSD, Takeda, Dr. Falk Pharma and Tillotts. Yamile Zabana has received support for conference attendance, speaker fees, research support and consulting fees of Abvvie, Adacyte, Almirall, Amgen, Dr. Falk, FAES Pharma, Ferring, Jannsen, MSD, Otsuka, Pfizer, Shire, Takeda and Tillots. Ana Gutiérrez has served as a speaker, a consultant and advisory member for or has received research funding from MSD, Abbvie, Pfizer, Kern Pharma, Takeda, Janssen, Ferring, Faes Farma, Shire Pharmaceuticals, Tillotts Pharma, Chiesi and Otsuka Pharmaceutical. Cristina Suárez Ferrer has served as a speaker or has received education funding from MSD, Abbvie, Pfizer, Janssen, Takeda and Ferring. José María Huguet has served as a speaker, or has received research or education funding from MSD, Abbvie, Pfizer, Takeda, Janssen, Sandoz, Ferring and Faes Farma. Luigi Melcarne has served as a speaker has received financial support for educational activities from MSD, Janssen, Abbie, Takeda, Ferring, Dr. Falk, Pfizer, Sandoz, Tillotts Pharma Ferring. José Manuel Benítez has served as a speaker, consultant and advisory member for or has received financial support for educational activities from Dr. Falk Pharma, Faes Farma, Ferring, Shire Pharmaceuticals, MSD, Abbvie, Takeda and Janssen. María Chaparro has served as a speaker, or has received research or education funding from MSD, Abbvie, Hospira, Pfizer, Takeda, Janssen, Ferring, Shire Pharmaceuticals, Dr. Falk Pharma, Tillotts Pharma. Javier P. Gisbert has served as a speaker, a consultant and advisory member for or has received research funding from MSD, Abbvie, Pfizer, Kern Pharma, Biogen, Mylan, Takeda, Janssen, Roche, Sandoz, Celgene, Gilead, Ferring, Faes Farma, Shire Pharmaceuticals, Dr. Falk Pharma, Tillotts Pharma, Chiesi, Casen Fleet, Gebro Pharma, Otsuka Pharmaceutical, and Vifor Pharma. José Miranda-Bautista, Iria Bastón-Rey, Francisco Mesonero, Carmen Cagigas Fernández, Ismael El Hajra, Nerea Hernández-Aretxabaleta, Isabel Pérez-Martínez, Esteban Fuentes-Valenzuela, Nuria Jiménez, Cristina Rubín de Célix, Agnes Fernández-Clotet, María González-Vivó, Blanca Del Val, Jesús Castro-Poceiro, Carmen Dueñas, Marta Izquierdo, David Monfort, Abdel Bouhmidi, Patricia Ramírez De la Piscina, Eva Romero, Gema Molina, Jaime Zorrilla, Cristina Calvino-Suárez, Eugenia Sánchez, Andrea Nuñez, Olivia Sierra, Beatriz Castro, Irene González-Partida, Saioa De la Maza, Andrés Castaño, Rodrigo Nájera-Muñoz, Luis Sánchez-Guillén, Micaela Riat Castro, José Luis Rueda, Pedro Delgado-Guillena, Carlos Tardillo, Elena Peña, Santiago Frago-Larramona, María Carmen Rodríguez-Grau, Rocío Plaza, Pablo Pérez-Galindo, Jesús Martínez-Cadilla, Rubén Sánchez-Aldehuelo, María Dolores De la Cruz, Ignacio Marín, Laura Nieto-García, Antonio López-San Román, José Manuel Herrera have no conflict of interest to declare.

Figures

Figure 1
Figure 1
Effect of biological treatment during the preoperative period on frequency of postoperative complications and infections by Chi-square test. (A), Inflammatory bowel disease. (B), Ulcerative colitis. (C), Crohn’s disease. Statistically significant differences (p ≤ 0.05) are indicated in the graphic.
See this image and copyright information in PMC

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