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-Reference-Cited by-同舟云学术

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

Published:2022-07-27 Issue:12 Volume:16 Page:1882-1892
ISSN:1873-9946
Container-title:Journal of Crohn's and Colitis
language:en
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Author:

Yanai Henit¹²,Kagramanova Anna³,Knyazev Oleg³⁴⁵,Sabino João⁶,Haenen Shana⁶,Mantzaris Gerassimos J⁷,Mountaki Katerina⁷,Armuzzi Alessandro⁸,Pugliese Daniela⁹,Furfaro Federica¹⁰,Fiorino Gionata¹¹^ORCID,Drobne David¹²¹³^ORCID,Kurent Tina¹³,Yassin Sharif²¹⁴,Maharshak Nitsan²¹⁴,Castiglione Fabiana¹⁵,de Sire Roberto¹⁵^ORCID,Nardone Olga Maria¹⁶,Farkas Klaudia¹⁷,Molnar Tamas¹⁷^ORCID,Krznaric Zeljko¹⁸,Brinar Marko¹⁸,Chashkova Elena¹⁹,Livne Margolin Moran²²⁰,Kopylov Uri²²⁰,Bezzio Cristina²¹,Bar-Gil Shitrit Ariella²²²³,Lukas Milan²⁴²⁵,Chaparro María²⁶²⁷^ORCID,Truyens Marie²⁸²⁹,Nancey Stéphane³⁰,Lobaton Triana²⁸²⁹,Gisbert Javier P²⁶²⁷,Saibeni Simone²¹^ORCID,Bacsúr Péter¹⁷,Bossuyt Peter³¹^ORCID,Schulberg Julien³²³³³⁴,Hoentjen Frank³⁵,Viganò Chiara³⁶³⁷,Palermo Andrea³⁶³⁷,Torres Joana³⁸³⁹^ORCID,Revés Joana³⁹,Karmiris Konstantinos⁴⁰,Velegraki Magdalini⁴⁰^ORCID,Savarino Edoardo⁴¹,Markopoulos Panagiotis⁴²,Tsironi Eftychia⁴²,Ellul Pierre⁴³,Calviño Suárez Cristina⁴⁴,Weisshof Roni⁴⁵⁴⁶,Ben-Hur Dana⁴⁵⁴⁶,Naftali Timna⁴⁷²,Eriksson Carl⁴⁸^ORCID,Koutroubakis Ioannis E⁴⁹,Foteinogiannopoulou Kalliopi⁴⁹^ORCID,Limdi Jimmy K⁵⁰,Liu Eleanor⁵⁰,Surís Gerard⁵¹,Calabrese Emma⁵²,Zorzi Francesca⁵²,Filip Rafał⁵³,Ribaldone Davide Giuseppe⁵⁴^ORCID,Snir Yifat¹²,Goren Idan¹²^ORCID,Banai-Eran Hagar¹²,Broytman Yelena¹²,Amir Barak Hadar¹²,Avni-Biron Irit¹²^ORCID,Ollech Jacob E¹²,Dotan Iris¹²,Aharoni Golan Maya⁵⁵⁵⁶⁵⁷

Affiliation:

1. Division of Gastroenterology, Rabin Medical Center , Petah Tikva , Israel

2. Sackler Faculty of Medicine, Tel Aviv University , Israel

3. Moscow Clinical Scientific Centre named after. A.S. Loginov , Moscow , Russian Federation

4. State Scientific Centre of Coloproctology named after A.N. Ryzhyh , Moscow , Russian Federation

5. Research Institute of Health Organization and Medical Management , Moscow , Russian Federation

6. Department of Gastroenterology, University Hospitals of Leuven , Leuven , Belgium

7. Department of Gastroenterology, GHA ‘Evaggelismos-Ophthalmiatreion Athinon-Polykliniki’ , Athens , Greece

8. IBD Center, IRCCS Humanitas Research Hospital, Rozzano , Milan , Italy

9. CEMAD, IBD UNIT, Unità Operativa Complessa di Medicina Interna e Gastroenterologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario ‘A. Gemelli’ IRCCS , Rome , Italy

10. IBD Center, Humanitas Research Hospital-IRCCS , Milan , Italy

11. Gastroenterology and Endoscopy, IRCCS Ospedale San Raffaele and Vita-Salute San Raffaele University , Milan , Italy

12. Department of Internal Medicine, Medical Faculty, University of Ljubljana , Ljubljana , Slovenia

13. Department of Gastroenterology, University Medical Centre Ljubljana , Ljubljana , Slovenia

14. Department of Gastroenterology and Liver Diseases, Tel Aviv Medical Center , Tel Aviv , Israel

15. Department of Clinical Medicine and Surgery, University of Naples Federico II , Naples , Italy

16. Department of Public Health, University of Naples Federico II , Naples , Italy

17. Department of Medicine, University of Szeged , Szeged , Hungary

18. Department of Gastroenterology, Hepatology and Nutrition, University Hospital Centre , Zagreb , Croatia

19. Irkutsk Scientific Center of Surgery and Traumatology , Russia

20. Department of Gastroenterology, Sheba Medical Center , Tel Hashomer , Israel

21. Gastroenterology Unit, Rho Hospital, ASST Rhodense , Rho (MI) , Italy

22. Digestive Diseases Institute, Shaare Zedek Medical Center , Jerusalem , Israel

23. Faculty of Medicine, Hebrew University , Jerusalem , Israel

24. Clinical and Research Centre for Inflammatory Bowel Disease, ISCARE Clinical Centre , Prague , Czech Republic

25. Institute of Medical Biochemistry and Laboratory Medicine, General University Hospital and First Faculty of Medicine, Charles University , Prague , Czech Republic

26. Department of Gastroenterology, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS- Princesa), Universidad Autónoma de Madrid (UAM) , Spain

27. Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd) , Madrid , Spain

28. IBD unit, Department of Gastroenterology, University Hospital Ghent , Ghent , Belgium

29. Department of Internal Medicine and Pediatrics, Ghent University , Ghent , Belgium

30. Department of Gastroenterology, Lyon-Sud hospital, Hospices Civils de Lyon, Lyon and INSERM U1111, CIRI , Lyon , France

31. Imelda GI clinical Research Center, Department of Gastroenterology, Imelda General Hospital , Bonheiden , Belgium

32. Department of Gastroenterology, St Vincent’s Hospital , Melbourne, VIC , Australia

33. Department of Medicine, University of Melbourne , Melbourne, VIC , Australia

34. Department of Gastroenterology, Austin Hospital , Melbourne, VIC , Australia

35. Inflammatory Bowel Disease Center, Department of Gastroenterology, Radboud University Medical Center, Nijmegen, The Netherlands and Division of Gastroenterology, Department of Medicine, University of Alberta , Edmonton , Canada

36. Division of Gastroenterology and Center for Autoimmune Liver Diseases, Department of Medicine and Surgery, University of Milano-Bicocca , Monza , Italy

37. European Reference Network on Hepatological Diseases (ERN RARE-LIVER), San Gerardo Hospital , Monza , Italy

38. Division of Gastroenterology, Hospital da Luz Lisboa , Portugal

39. Division of Gastroenterology, Hospital Beatriz Ângelo , Loures, Lisbon , Portugal

40. Department of Gastroenterology, Venizeleio General Hospital , Heraklion, Crete , Greece

41. Department of Surgical Oncological & Gastroenterological Sciences (DiSCOG), Gastroenterology Unit, Padua University , Padua , Italy

42. Department of Gastroenterology, Metaxa Memorial General Hospital , Piraeus , Greece

43. Division of Gastroenterology Mater Dei Hospital , Msida , Malta

44. Department of Gastroenterology and Hepatology, University Hospital of Santiago de Compostela , Santiago de Compostela , Spain

45. Department of Gastroenterology, Rambam Health Care Campus , Haifa , Israel

46. Rappaport Faculty of Medicine, The Technion – Israel Institute of Technology , Haifa , Israel

47. Institute of Gastroenterology, Meir Hospital Sapir Medical Center , Kfar Saba , Israel

48. Department of Gastroenterology, Faculty of Medicine and Health, Örebro University , Örebro , Sweden

49. Gastroenterology Department, University Hospital of Heraklion , Crete , Greece

50. Department of Gastroenterology, The Northern Care Alliance NHS Foundation Trust, Manchester Academic Health Sciences, University of Manchester , Manchester , UK

51. Gastroenterology Department, Hospital de Bellvitge and IDIBELL, L’Hospitalet , Spain

52. Gastroenterology Unit, Department of Systems Medicine, University of Rome Tor Vergata , Italy

53. Department of Gastroenterology with IBD Unit , Clinical Hospital No. 2, Rzeszów , Poland

54. Department of Medical Sciences, University of Turin , Turin , Italy

55. Department of Gastroenterology and Hepatology, Kaplan Medical Center , Rehovot , Israel

56. Faculty of Medicine, Hebrew University of Jerusalem , Jerusalem , Israel

57. Concord Medical Center, Clalit Health Services , Bnei Brak , Israel

Abstract

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.

Publisher

Oxford University Press (OUP)

Subject

Gastroenterology,General Medicine

Link

https://academic.oup.com/ecco-jcc/advance-article-pdf/doi/10.1093/ecco-jcc/jjac100/45556663/jjac100.pdf

Reference32 articles.

1. Crohn’s disease;Torres;Lancet,2017

2. Cumulative incidence of second intestinal resection in Crohn’s disease: a systematic review and meta-analysis of population-based studies;Frolkis;Am J Gastroenterol,2014

3. ECCO guidelines on therapeutics in Crohn’s disease: surgical treatment.;Adamina;J Crohns Colitis,2020

4. Predictability of the postoperative course of crohn’s disease;Rutgeerts;Gastroenterology,1990

5. ECCO guidelines on therapeutics in Crohn’s disease: medical treatment.;Torres;J Crohns Colitis,2020

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