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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 Multicenter European Study.
Austin 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, Ariella Bar-Gil;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;Barak, Hadar Amir;Avni-Biron, Irit;Ollech, Jacob E;Dotan, Iris;Aharoni Golan, Maya
Affiliation: Division of Gastroenterology, Rabin Medical Center, Petah Tikva, Israel..
Sackler Faculty of Medicine, Tel Aviv University, Israel..
Moscow Clinical Scientific Centre named after. A.S. Loginov, Moscow, Russia..
State Scientific Centre of Coloproctology named after A.N. Ryzhyh, Moscow, Russian Federation..
Research Institute of Health Organization and Medical Management, Moscow, Russian Federation..
Department of Gastroenterology, University Hospitals of Leuven, Leuven, Belgium..
Department of Gastroenterology, GHA "Evaggelismos-Ophthalmiatreion Athinon-Polykliniki", Athens, Greece..
IBDUnit, IRCCS Humanitas Research Hospital, Department of Biomedical Sciences Humanitas University, Milan, Italy..
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..
IBD Center, Humanitas Research Hospital-IRCCS, Milan, Italy..
Gastroenterology and Endoscopy, IRCCS Ospedale San Raffaele and Vita-Salute San Raffaele University, Milan, Italy..
Department of Internal Medicine, Medical Faculty, University of Ljubljana, Ljubljana, Slovenia..
Department of Gastroenterology, University Medical Centre Ljubljana, Ljubljana, Slovenia..
Department of Gastroenterology and Liver Diseases, Tel Aviv Medical Center, Tel Aviv, Israel..
Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy..
Department of Public Health, University of Naples Federico II, Naples Italy..
Department of Medicine, University of Szeged, Szeged, Hungary..
Department of Gastroenterology, Hepatology and Nutrition, University Hospital Centre, Zagreb, Croatia..
Irkutsk Scientific Center of Surgery and Traumatology, Russia..
Department of Gastroenterology, Sheba medical center, Tel Hashomer, Israel..
Gastroenterology Unit, Rho Hospital, ASST Rhodense, Rho (MI), Italy..
Digestive Diseases Institute, Shaare Zedek Medical Center, Jerusalem, Israel..
Faculty of Medicine, Hebrew University, Jerusalem, Israel..
Clinical and Research Centre for Inflammatory Bowel Disease, ISCARE Clinical Centre, Prague, Czech Republic..
Institute of Medical Biochemistry and Laboratory Medicine, General University Hospital and First Faculty of Medicine, Charles University, Prague, Czech Republic..
Department of Gastroenterology, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS- Princesa), Universidad Autónoma de Madrid (UAM), Spain..
Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain..
IBD unit, Department of Gastroenterology, University Hospital Ghent, Ghent, Belgium..
Department of Internal Medicine and Pediatrics, Ghent University, Ghent, Belgium..
Department of Gastroenterology, Lyon-Sud hospital, Hospices Civils de Lyon, Lyon and INSERM U1111, CIRI, Lyon, France..
Imelda GI clinical research center, department of gastroenterology, Imelda General Hospital, Bonheiden, Belgium..
Department of Gastroenterology, St Vincent's Hospital, Melbourne, VIC, Australia..
Department of Medicine, University of Melbourne, Melbourne, VIC, Australia..
Gastroenterology and Hepatology
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..
Division of Gastroenterology and Center for Autoimmune Liver Diseases, Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy..
European Reference Network on Hepatological Diseases (ERN RARE-LIVER), San Gerardo Hospital, Monza, Italy..
Division of Gastroenterology, Hospital da Luz Lisboa, Portugal..
Division of Gastroenterology, Hospital Beatriz Ângelo, Loures, Lisbon, Portugal..
Department of Gastroenterology, Venizeleio General Hospital, Heraklion, Crete, Greece..
Department of Surgical Oncological & Gastroenterological Sciences (DiSCOG), Gastroenterology Unit, Padua University, Padua, Italy..
Department of Gastroenterology, Metaxa Memorial General Hospital, Piraeus, Greece..
Division of Gastroenterology Mater Dei Hospital, Msida, Malta..
Department of Gastroenterology and Hepatology, University Hospital of Santiago de Compostela, Santiago de Compostela, Spain..
Department of Gastroenterology, Rambam Health Care Campus, Haifa, Israel..
Rappaport Faculty of Medicine, The Technion - Israel Institute of Technology, Haifa, Israel..
Institute of gastroenterology, Meir Hospital Sapir Medical Center, Kfar Saba, Israel..
Department of Gastroenterology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden..
Gastroenterology Department, University Hospital of Heraklion, Crete, Greece..
Department of Gastroenterology, The Northern Care Alliance NHS Foundation Trust, Manchester Academic Health Sciences, University of Manchester, Manchester, UK..
Gastroenterology Department, Hospital de Bellvitge and IDIBELL, L'Hospitalet, Spain..
Gastroenterology Unit, Department of Systems Medicine, University of Rome Tor Vergata, Italy..
Department of Gastroenterology with IBD Unit, Clinical Hospital No. 2, Rzeszów, Poland..
Department of Medical Sciences, University of Turin, Turin, Italy..
Department of Gastroenterology and Hepatology, Kaplan Medical Center, Rehovot, Israel..
Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel..
Concord Medical Center, Clalit Health Services, Bnei Brak, Israel..
Issue Date: 27-Jul-2022
Date: 2022
Publication information: Journal of Crohn's & colitis 2022; online first: 27 July
Abstract: 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-TNF therapy to vedolizumab (VDZ) and ustekinumab (UST) in a real-world setting. A retrospective multicenter study of CD-adults after curative ICR on early prophylaxis. 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. Included 297 patients (53.9% males, age at diagnosis 24y[19-32], age at ICR-34y[26-43], 18.5% smokers, 27.6% biologic-naïve, 65.7% anti-TNF experienced, 28.6%≥2 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: anti-TNF 40.2%, VDZ 33% and UST 61.8%. Risk factors for ePOR at 1-year: past-infliximab (adj.OR=1.73[95%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. 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.
DOI: 10.1093/ecco-jcc/jjac100
ORCID: 0000-0001-5623-2968
Journal: Journal of Crohn's & colitis
PubMed URL: 35895074
PubMed URL:
Type: Journal Article
Subjects: Biologics
Crohn’s disease
Post-operative recurrence
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