Infliximab and complications after colectomy in patients with ulcerative colitis

Abstract

The use of infliximab does not seem to associate with an increased risk of short-term postoperative complications in ulcerative colitis.

Meta‐analysis: peri‐operative anti‐TNFα treatment and post‐operative complications in patients with inflammatory bowel disease

“…Four studies reported a mixed cohort of IBD patients, one of which was excluded due to a low NOS score . Overall, 18 studies with 4659 participants were eligible for meta‐analysis . Infectious complication rates could be calculated for 16 of these studies, non‐infectious complications for 14, and total complication rates for 15 studies.…”

“…Study endpoints are also presented in Table S1. Infliximab was given in the 12 weeks prior to surgery in ten studies, 8 weeks prior in four studies, and permitted beyond 12 weeks but largely given within 12 weeks in four studies . Most studies that included patients with adalimumab and certolizumab did not specify the interval from last dose to surgery, except for one where it was given in the 4 weeks preceding surgery …”

“…Most studies did not report clearly the interval between the last dose of anti‐TNFα therapy and surgery. Several studies included patients within a peri‐operative infliximab group if they had received the last dose within the 12 weeks of surgery . The study by Waterman et al .…”

Clinical audit: recent practice in caring for patients with acute severe colitis compared with published guidelines – is there a problem?

“…ASC constitutes a medical emergency that may result in death or necessitate emergency colectomy. While some regard colectomy as a cure for UC, it can be associated with short‐term morbidity …”

Strategies for the Care of Adults Hospitalized for Active Ulcerative Colitis

“…If one chooses to treat a patient with a thiopurine, they should be tested for TPMT at the time of admission, because of prolonged testing turn-around times. Although earlier data indicated an increased risk of post-operative complications in patients treated with infliximab (47–49), several more-recent studies found no increased post-operative outcomes after infliximab use (50–54). …”