Naslov
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
(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)

Autori
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 ; Krznarić, Željko ; Brinar, Marko ; Chashkova, Elena ; Livne Margolin, Moran ; Kopylov, Uri ; Bezzio, Cristina ; Bar-Gil Shitrit, Ariella ; 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 ; Calviño Suárez, Cristina ; 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 ; Aharoni Golan, Maya

Izvornik
Journal of Crohn's and Colitis (1873-9946) 16 (2022), 12; 1882-1892

Vrsta, podvrsta i kategorija rada
Radovi u časopisima, članak, znanstveni

Ključne riječi
Crohn’s disease ; biologics ; post-operative recurrence

Sažetak
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.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

POVEZANOST RADA