Prevention of post-operative recurrence of Crohn's disease among patients with prior anti-TNFα failure: A retrospective multicenter study

Background: Anti-TNF & alpha; are recommended for preventing Crohn's disease (CD) postoperative recurrence (POR) in patients with risk factors. However, few data exploring anti-TNF & alpha; efficacy in patients with pre-operative anti-TNF & alpha; failure are available so far.Aims: The aim of the present study was to compare the efficacy of anti-TNF & alpha; with other biologics and immunosuppressants to prevent POR in this setting. Methods: Consecutive CD patients who underwent bowel resection between January 2010 and December 2019 after failure of at least one anti-TNF & alpha; were retrospectively included among three tertiary centers if they started a postoperative medical prophylaxis within the three months after index surgery. The main outcome was to compare rates of objective recurrence (endoscopic or radiological recurrence in absence of colonoscopy) between patients treated with an anti-TNF & alpha; agent or another treatment as prevention of POR.Results: Among the 119 patients included, 71 patients received an anti-TNF & alpha; (26 infliximab, 45 adali-mumab) and 48 another treatment (18 ustekinumab, 7 vedolizumab, 20 azathioprine and 3 methotrexate) to prevent POR. Rates of objective recurrence at two years were 23.9% in patients treated with anti-TNF & alpha; and 44.9% in the others (p = 0.011).Conclusion: Anti-TNF & alpha; remained an effective option to prevent POR for patients operated upon with previous anti-TNF & alpha; failure.& COPY; 2022 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

Automated summary

This study compared the efficacy of anti-TNF-α with other biologics and immunosuppressants in preventing postoperative recurrence of Crohn's disease. The results showed that patients treated with anti-TNF-α had a lower recurrence rate.