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

Yanai, Henit; Каграманова, А В; Knyazev, Oleg; Sabino, J; 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; Sire, Roberto de; Nardone, Olga Maria; Farkas, Klaudia; Molnár, Tamás; Krznarić, Željko; Brinar, Marko; Chashkova, E. Yu.; Margolin, Moran Livne; Kopylov, Uri; Bezzio, Cristina; Shitrit, Ariella Bar‐Gil; Lukáš, Milan; Chaparro, María; Truyens, Marie; Nancey, Stéphane; Lobatón, 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; Weisshof, Roni; Ben-Hur, Dana; Naftali, Timna; Eriksson, Carl; Koutroubakis, Ioannis Ε.; 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; Dotan, Iris; Golan, Maya Aharoni

doi:10.1093/ecco-jcc/jjac100

Cited by 33 publications

(25 citation statements)

References 33 publications

(51 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Several other retrospective studies looked at the utility of ustekinumab or vedolizumab in the post-operative setting. A retrospective multicenter study found rates of endoscopic post-operative recurrence, defined as Rutgeerts score of >i1 or colonic-segmental-SES-CD of >5 within 1 year, as 33% for vedolizumab and 61.8% for ustekinumab; the authors also found that patients treated with vedolizumab or ustekinumab tended to have more experience with prior biologics and surgery [ 80 ]. A small retrospective study defining endoscopic recurrence as Rutgeerts score of >i1 at 6 months found that after inversed probability of treatment weighting, endoscopic recurrence was lower with ustekinumab compared with AZA (28.0% vs 54.5%, P = 0.029) [ 81 ].…”

Section: Resultsmentioning

confidence: 99%

Post-operative prevention and monitoring of Crohn’s disease recurrence

Lee

Cantrell

Shen

et al. 2022

Gastroenterology Report

View full text Add to dashboard Cite

Crohn’s disease (CD) and ulcerative colitis (UC) are relapsing and remitting chronic inflammatory diseases of the gastrointestinal tract. Although surgery for UC can provide a cure, surgery for CD is rarely curative. In the past few decades, research has identified risk factors for postsurgical CD recurrence, enabling patient risk stratification to guide monitoring and prophylactic treatment to prevent CD recurrence. A MEDLINE literature review identified articles regarding post-operative monitoring of CD recurrence after resection surgery. In this review, we discuss the evidence on risk factors for post-operative CD recurrence as well as suggestions on post-operative management.

show abstract

Section: Resultsmentioning

confidence: 99%

Post-operative prevention and monitoring of Crohn’s disease recurrence

Lee

Cantrell

Shen

et al. 2022

Gastroenterology Report

View full text Add to dashboard Cite

show abstract

“… 25 , 26 Recent data have also shown that both vedolizumab and ustekinumab may be used in this setting with results comparable to anti‐TNFs. 10 , 27 In our “prophylaxis group”, no difference was found in endoscopic recurrence rates between patients administered with anti‐TNF agents and those with other immunomodulators, although it is difficult to draw conclusions in the absence of adequate power for this analysis.…”

Section: Discussionmentioning

confidence: 91%

“… 4 The postoperative recurrence (POR) of CD is more likely to occur in the presence of any of the known clinical risk factors, such as smoking, prior intestinal surgery, penetrating disease at index surgery, perianal location, and extensive small bowel resection (>50 cm). 5 , 6 , 7 , 8 , 9 On the other hand, it has been shown that early treatment with thiopurines or anti‐TNF 10 as well as the use of Kono‐S anastomosis 11 play some protective role.…”

Section: Introductionmentioning

confidence: 99%

Comparison of two strategies for the management of postoperative recurrence in Crohn’s disease patients with one clinical risk factor: A multicentre IG‐IBD study

Dragoni

Castiglione

Bezzio³

et al. 2023

UEG Journal

Self Cite

View full text Add to dashboard Cite

Background The management of postoperative recurrence (POR) in Crohn's disease (CD) after ileo‐colonic resection is a highly debated topic. Prophylactic immunosuppression after surgery is currently recommended in the presence of at least one clinical risk factor. Objective Our aim was to determine whether early immunosuppression can be avoided and guided by endoscopy in CD patients with only one risk factor. Methods CD patients with only one risk factor for POR, including previous intestinal resection, extensive small intestine resection (>50 cm), fistulising phenotype, history of perianal disease, and active smoking, were retrospectively included. Two groups were formed based on whether immunosuppression was started immediately after surgery (“prophylaxis group”) or guided by endoscopy (“endoscopy‐driven group”). Primary endpoints were rates of any endoscopic recurrence (Rutgeerts ≥ i2a) and severe endoscopic recurrence (i4) within 12 months after surgery. Secondary outcomes were clinical recurrence rates at 6, 12 and 24 months after surgery. Results A total of 195 patients were enroled, of whom 61 (31.3%) received immunoprophylaxis. No differences between immunoprophylaxis and the endoscopy‐driven approach were found regarding any endoscopic recurrence (36.1% vs. 45.5%, respectively, p = 0.10) and severe endoscopic recurrence (9.8% vs. 15.7%, respectively, p = 0.15) at the first endoscopic evaluation. Clinical recurrence rates were also not statistically different (p = 0.43, p = 0.09, and p = 0.63 at 6, 12, and 24 months, respectively). Conclusions In operated CD patients with only one risk factor for POR, immediate immunoprophylaxis does not decrease the rate of early clinical and endoscopic recurrence. Prospective studies are needed to confirm our results.

show abstract

“…В частности, рассмотрены как различные возрастные группы, так и подкожный и внутривенный пути введения, а также 4-, 8-и 12-недельный режимы введения. Отдельно рассмотрены возможности применения устекинумаба у беременных [8], педиатрических пациентов [9], у лиц, перенесших хирургическое вмешательство по поводу болезни Крона [10][11][12], а также лиц, имеющих внекишечные проявления заболевания [13]. В качестве критериев эффективности выступали как клинические проявления, так и эндоскопические и лабораторные показатели.…”

Section: Bowel Diseaseunclassified

Efficacy and safety of ustekinumab therapy in patients with Crohn’s disease. Real clinical practice

et al. 2022

View full text Add to dashboard Cite

Introduction.The results of registrational clinical trials (CTs) and real clinical practice do not always correlate. The task of practitioners is to find optimal approaches to the therapy of Crohn’s disease, based on the analysis of clinical trials and real-world data.Aim. To make a retrospective assessment of the efficacy and tolerability of UST therapy in patients with moderate to severe CD in real clinical practice.Materials and methods. A total of 88 patients with CD were included in the study to evaluate the efficacy and safety of UST. Among the patients, men accounted for 48.9%, women – 51.1%, the average age was 36.4 ± 4.8 years, the disease duration was 7.8 ± 2.1 years. 67.1% of patients with moderate CD in the form of ileocolitis (82.9%) had a stenosing (26.1%) and penetrating (50.0%) form of the disease. 95.4% of patients received prior immunosuppressive therapy.Results. After inductive therapy with UST, clinical response and clinical remission within 8 weeks were recorded in 86 (97.7%) patients with CD. After 26 weeks, 58 (65.9%) patients achieved clinical remission, 28 (31.8%) patients with CD and all patients who responded to UST therapy maintained clinical response. Crohn’s Disease Activity Index (CDAI) decreased from 445.8 ± 50.4 to 134.6 ± 21.4 points. Clinically significant endoscopic improvement was reported in 25 (40.3%) of 62 patients, endoscopic response in 14 (22.6%) patients, endoscopic remission in 18 (29.0%). After 26 weeks, CDAI decreased from 7.8 ± 1.8 to 2.9 ± 1.2 points, after 52 weeks it decreased from 445.8 ± 50.4 to 141.6 ± 28.2. Steroid-free remission in CD patients accounted for 68.2%. 1-year survival of UST therapy was 97.7%, 2-year survival was 95.5%.Conclusions. The observation demonstrated the high efficacy of the drug in induction and maintenance therapy in the cohort of patients with severe to moderate CD resistant to disease-modifying and genetically engineered biological drugs.

show abstract

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

Cited by 33 publications

References 33 publications

Post-operative prevention and monitoring of Crohn’s disease recurrence

Post-operative prevention and monitoring of Crohn’s disease recurrence

Comparison of two strategies for the management of postoperative recurrence in Crohn’s disease patients with one clinical risk factor: A multicentre IG‐IBD study

Efficacy and safety of ustekinumab therapy in patients with Crohn’s disease. Real clinical practice

Contact Info

Product

Resources

About