Disease recurrence in patients with Crohn's disease after biologic therapy or surgery: a meta-analysis.
Adalimumab
Crohn’s disease
Infliximab
Recurrence
Resection
Journal
International journal of colorectal disease
ISSN: 1432-1262
Titre abrégé: Int J Colorectal Dis
Pays: Germany
ID NLM: 8607899
Informations de publication
Date de publication:
Oct 2022
Oct 2022
Historique:
accepted:
18
09
2022
pubmed:
24
9
2022
medline:
18
10
2022
entrez:
23
9
2022
Statut:
ppublish
Résumé
Relapse is a problem in patients with Crohn's disease (CD) after medical therapy (including biologics) and after surgery to treat acute inflammation. It is unclear whether the recurrence rate over time is higher after surgical therapy than after continuous drug treatment. We sought to compare clinical relapse rates and the need for re-interventions (resection or therapeutic endoscopic intervention) in patients with CD. A meta-analysis was performed according to PRISMA guidelines. The need for one of the three re-interventions (surgery, biologics or both) increased over time. The recurrence rates in patients after ileocecal resection were lower than the rates under biologic therapy. The odds ratio for clinical recurrence under biologics versus after surgical treatment was 2.50 (95% confidence interval [CI] 1.53-4.08, p-value < 0.001). The odds ratio for surgical recurrence under biologics versus after surgery was 3.60 (95% CI 1.06-12.3, p-value 0.041). These findings support surgical resection as a treatment option in patients with CD with limited disease.
Sections du résumé
BACKGROUND
BACKGROUND
Relapse is a problem in patients with Crohn's disease (CD) after medical therapy (including biologics) and after surgery to treat acute inflammation. It is unclear whether the recurrence rate over time is higher after surgical therapy than after continuous drug treatment.
AIM
OBJECTIVE
We sought to compare clinical relapse rates and the need for re-interventions (resection or therapeutic endoscopic intervention) in patients with CD.
METHODS
METHODS
A meta-analysis was performed according to PRISMA guidelines.
RESULTS
RESULTS
The need for one of the three re-interventions (surgery, biologics or both) increased over time. The recurrence rates in patients after ileocecal resection were lower than the rates under biologic therapy. The odds ratio for clinical recurrence under biologics versus after surgical treatment was 2.50 (95% confidence interval [CI] 1.53-4.08, p-value < 0.001). The odds ratio for surgical recurrence under biologics versus after surgery was 3.60 (95% CI 1.06-12.3, p-value 0.041).
CONCLUSION
CONCLUSIONS
These findings support surgical resection as a treatment option in patients with CD with limited disease.
Identifiants
pubmed: 36149447
doi: 10.1007/s00384-022-04254-z
pii: 10.1007/s00384-022-04254-z
pmc: PMC9560971
doi:
Substances chimiques
Biological Products
0
Infliximab
B72HH48FLU
Types de publication
Journal Article
Meta-Analysis
Langues
eng
Sous-ensembles de citation
IM
Pagination
2185-2195Commentaires et corrections
Type : ErratumIn
Informations de copyright
© 2022. The Author(s).
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