期刊
DIGESTION
卷 96, 期 3, 页码 166-172出版社
KARGER
DOI: 10.1159/000480231
关键词
Anti-tumour necrosis factor; Crohn's disease; Abdominal surgery; Recurrence
资金
- Nikkiso Europe
- Janssen
- Pfizer
- MSD
- Abbvie
- Merck
- Abbott
- Genentech
- Mitsubishi
- Ferring
- Norgine
- Tillots
- Vifor
- Shire
- Therakos
- Pharmacosmos
- Pilege
- BMS
- BMS, UCB-pharma
- Hospira
- Celltrion
- Takeda
- Boerhinger-Ingelheim
- Lilly
- HAC-pharma
- Astra Zeneca
- Chiesi
- Otsuka
- Zambon
Background: Most Crohn's disease (CD) patients develop endoscopic recurrence within one year of intestinal resection. The best treatment method to prevent post-operative CD recurrence remains uncertain. Methods: A total of 155 CD patients from 2 referral centres, who were undergoing intestinal resection with ileo-colonic anastomosis (January 2004-January 2015), were included. All subjects received preventive therapy with tumour necrosis factor antagonists (anti-TNFs), thiopurinesor mesalazine. The primary outcome was the rate of endoscopic recurrence (Rutgeerts score >= i(2)) in the 3 treatment groups. Results: Patients treated with anti-TNFs were at significantly lower risk of endoscopic recurrence during the follow-up than those receiving thiopurines or mesalazine (incidence rates of 2.2, 3.0 and 4.8 per 100 person- months, respectively, log-rank, p = 0.011). The median time to recurrence was significantly longer in patients treated with anti-TNFs than in those who received thiopurines or mesalazine (37.0, 13.7, and 16.8 months, respectively, logrank, p = 0.011). Anti-TNFs were more effective than mesalazine (univariable analysis, hazard ratio [HR] 0.45, 95% CI 0.26-0.77, p = 0.004; multivariable analysis, HR 0.45, 95% CI 0.26-0.77, p = 0.004), and non-significantly superior over thiopurines. Conclusion: Anti-TNF therapy was the most effective strategy for the prevention of endoscopic CD recurrence. (C) 2017 S. Karger AG, Basel
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