Perioperative Anti-Tumor Necrosis Factor Therapy Does Not Increase the Rate of Early Postoperative Complications in Crohn’s Disease

Nasir, Basil S.; Dozois, Eric J.; Cima, Robert R.; Pembérton, John H.; Wolff, Bruce G.; Sandborn, William J.; Loftus, Edward V.; Larson, David W.

doi:10.1007/s11605-010-1341-5

Cited by 92 publications

(62 citation statements)

References 15 publications

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“…The lack of an association between preoperative infliximab use and postoperative complications in our study is consistent with most previous studies in this area 13,14,16–18,24 . One study showed a protective effect of preoperative anti-TNFα use, which lead to a decrease in the risk for surgical site infections in patient with penetrating Crohn’s disease (OR 0.1, p<0.01) 12 .…”

Section: Discussionsupporting

confidence: 93%

“…In some studies, the timing of the last dose is quantified as a range, such as within three months or 8 weeks of surgery 10, 13 . Some also include postoperative administration of anti-TNFα therapy, up to 4 weeks after surgery, into the study cohort 13, 16 . The aim of our study was to assess for an association between the duration of time, in days, between the last preoperative dose of anti-TNFα therapy (infliximab) and the risk for postoperative complications among IBD patients.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Timing of Last Preoperative Dose of Infliximab Does Not Increase Postoperative Complications in Inflammatory Bowel Disease Patients

et al. 2016

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Background The association between preoperative use of infliximab and postoperative complications in patients with inflammatory bowel disease (IBD) is a subject of continued debate. Results from studies examining an association between the timing of last preoperative dose of infliximab and postoperative complications remain inconsistent. Aims To assess if timing of last dose of infliximab prior to surgery affects the rate of postoperative complications in patients with Crohn’s disease or ulcerative colitis Methods Retrospective chart review of IBD patients who have undergone surgery while receiving therapy with infliximab was conducted. Forty seven patients were included in the analysis. Results No significant association was found between timing of infliximab and the rate of postoperative complications. Age, gender, disease type, steroid use, preoperative status, surgery type or surgeon type were not associated with increased rate of postoperative complications. Conclusion Timing of last dose of infliximab does not affect the rate of postoperative complications in patients with Crohn’s disease or ulcerative colitis.

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Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Timing of Last Preoperative Dose of Infliximab Does Not Increase Postoperative Complications in Inflammatory Bowel Disease Patients

et al. 2016

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“…Therefore, these studies found no association between perioperative use of inXiximab and postoperative surgical complications in patients with Crohn's disease undergoing bowel surgery. One recent larger study examining the relationship between anti-TNF therapy and postoperative outcome in Crohn's disease concluded that treatment with anti-TNF perioperatively is safe [65]. However, some rheumatologists may argue 'seronegative conditions' diVer from RA in both its natural history and disease pathogenesis.…”

Section: Discussionmentioning

confidence: 99%

Should anti-TNF therapy be discontinued in rheumatoid arthritis patients undergoing elective orthopaedic surgery? A systematic review of the evidence

et al. 2011

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Anti-tumour necrosis factor (TNF) therapies have revolutionized the management of rheumatoid arthritis (RA). A high proportion of RA patients are now established users of anti-TNF agents. Unfortunately, many RA patients with longstanding disease still require elective orthopaedic procedures. Published studies on the influence of TNF antagonist on infection rates in RA patients undergoing surgery are conflicting. However, national registries of RA patients on anti-TNF reported an increased risk of infection. The risk of anti-TNF-related infection is highest at the start of treatment with frequent involvement of the skin and subcutaneous tissue. Infection at these sites could negatively influence the healing of surgical wound. Current guidelines suggest that treatment with biologics should be discontinued prior to surgery. Patients with established disease are more likely to flare compared to those with early disease on stopping treatment. Consequently, TNF blockers need to be reinstated promptly after surgery to avoid the risk of RA flare.

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“…Marchal et al in their retrospective study describe a trend toward an increased early postsurgical infection rate in patients treated with infliximab before surgery though these patients were likely treated with corticosteroids and/or immunosuppressive agents as well [83]. Other retrospective studies have failed to show an increase in postoperative infections or other complications in patients treated perioperatively with anti-TNF agents [84][85][86]. A meta-analysis by Kopylov et al including eight studies found a trend toward an increased rate of total complications in patients treated with anti-TNF agents with infectious complications -mostly remote form the surgical site -being modestly but significantly elevated [87].…”

Section: Perioperative Complications In Patients Receiving Anti-tnf Amentioning

confidence: 99%

Surgery for Crohn’s disease and anti-TNF agents: the changing scenario

Sorrentino

Fogel

Bogaerde

2013

Expert Review of Gastroenterology & Hepatology

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Surgery has been a mainstay of therapy for Crohn's disease for a long time, essentially as a consequence of the fairly modest efficacy of traditional medications such as immunomodulators, antibiotics and 5-ASA, especially in severe cases. However, in the past decade and half, the advent of anti-TNF agents has greatly changed the medical approach to this disease and may modify its general management as well. Here, we have reviewed the current literature on incidence of surgery, timing of surgery and postoperative recurrence of Crohn's disease before and after the advent of anti-TNF agents. In addition, we have reviewed the risk of perioperative complications in patients on anti-TNF agents before surgery. The data show that the use of these medications is changing or expecting to change shortly a number of surgical aspects of Crohn's disease management.

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Perioperative Anti-Tumor Necrosis Factor Therapy Does Not Increase the Rate of Early Postoperative Complications in Crohn’s Disease

Abstract: The use of anti-TNF therapy in the perioperative period is safe and is not associated with an increase in overall or infectious complications in Crohn disease patients undergoing surgery.

Cited by 92 publications

References 15 publications

Timing of Last Preoperative Dose of Infliximab Does Not Increase Postoperative Complications in Inflammatory Bowel Disease Patients

Timing of Last Preoperative Dose of Infliximab Does Not Increase Postoperative Complications in Inflammatory Bowel Disease Patients

Should anti-TNF therapy be discontinued in rheumatoid arthritis patients undergoing elective orthopaedic surgery? A systematic review of the evidence

Surgery for Crohn’s disease and anti-TNF agents: the changing scenario

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