Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2022 Dec 5;16(12):1882-1892.
doi: 10.1093/ecco-jcc/jjac100.

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

Henit Yanai  1   2 , Anna Kagramanova  3 , Oleg Knyazev  3   4   5 , João Sabino  6 , Shana Haenen  6 , Gerassimos J Mantzaris  7 , Katerina Mountaki  7 , Alessandro Armuzzi  8 , Daniela Pugliese  9 , Federica Furfaro  10 , Gionata Fiorino  11 , David Drobne  12   13 , Tina Kurent  13 , Sharif Yassin  2   14 , Nitsan Maharshak  2   14 , Fabiana Castiglione  15 , Roberto de Sire  15 , Olga Maria Nardone  16 , Klaudia Farkas  17 , Tamas Molnar  17 , Zeljko Krznaric  18 , Marko Brinar  18 , Elena Chashkova  19 , Moran Livne Margolin  2   20 , Uri Kopylov  2   20 , Cristina Bezzio  21 , Ariella Bar-Gil Shitrit  22   23 , Milan Lukas  24   25 , María Chaparro  26   27 , Marie Truyens  28   29 , Stéphane Nancey  30 , Triana Lobaton  28   29 , Javier P Gisbert  26   27 , Simone Saibeni  21 , Péter Bacsúr  17 , Peter Bossuyt  31 , Julien Schulberg  32   33   34 , Frank Hoentjen  35 , Chiara Viganò  36   37 , Andrea Palermo  36   37 , Joana Torres  38   39 , Joana Revés  39 , Konstantinos Karmiris  40 , Magdalini Velegraki  40 , Edoardo Savarino  41 , Panagiotis Markopoulos  42 , Eftychia Tsironi  42 , Pierre Ellul  43 , Cristina Calviño Suárez  44 , Roni Weisshof  45   46 , Dana Ben-Hur  45   46 , Timna Naftali  47   2 , Carl Eriksson  48 , Ioannis E Koutroubakis  49 , Kalliopi Foteinogiannopoulou  49 , Jimmy K Limdi  50 , Eleanor Liu  50 , Gerard Surís  51 , Emma Calabrese  52 , Francesca Zorzi  52 , Rafał Filip  53 , Davide Giuseppe Ribaldone  54 , Yifat Snir  1   2 , Idan Goren  1   2 , Hagar Banai-Eran  1   2 , Yelena Broytman  1   2 , Hadar Amir Barak  1   2 , Irit Avni-Biron  1   2 , Jacob E Ollech  1   2 , Iris Dotan  1   2 , Maya Aharoni Golan  55   56   57
Affiliations
Multicenter Study

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

Henit Yanai et al. J Crohns Colitis. .

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 probability 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.

Keywords: Crohn’s disease; biologics; post-operative recurrence.

PubMed Disclaimer

Publication types