Postoperative Outcomes in Ustekinumab-Treated Patients Undergoing Abdominal Operations for Crohn’s Disease

Lightner, Amy L.; McKenna, Nicholas P.; Tse, Chung Sang; Hyman, Neil; Smith, Radhika; Ovsepyan, Gayane; Fleshner, Phillip; Crowell, Kristen T.; Koltun, Walter A.; Ferrante, Marc; D’Hoore, André; Lauwers, Nathalie; Verstockt, Bram; Spinelli, Antonino; DiCandido, Francesca; Raffals, Laura E.; Mathis, Kellie L.; Loftus, Edward V.

doi:10.1093/ecco-jcc/jjx163

Cited by 74 publications

(52 citation statements)

References 23 publications

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“…Perioperative safety outcomes of patients exposed to ustekinumab were assessed in two retrospective multicenter cohort studies. 60,61 Ustekinumab use was not observed, in both studies, to be associated with the increased risk of postoperative surgical site infection when compared with anti-TNF-treated patients. This is in spite of a higher use of concomitant immunosuppressants in the ustekinumab group in the study by Shim et al The study by Lightner et al, however, noted an increased risk of reoperation in the ustekinumab cohort.…”

Section: Safety Of Ustekinumab In Special Populationsmentioning

confidence: 71%

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A review of vedolizumab and ustekinumab for the treatment of inflammatory bowel diseases

et al. 2018

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Recent advancement in the understanding of the pathophysiology of inflammatory bowel disease has seen an expansion in therapeutic options. Vedolizumab, a selective α4β7 inhibitor, and ustekinumab, an IL 12/23 p40 inhibitor, have provided the much‐awaited out‐of‐class alternatives for patients who have failed or who are intolerant to anti‐Tumor Necrosis Factor (TNF) therapy. However, questions remain as to how we may best use these novel therapeutic agents. We evaluate the evidence available from randomized controlled trials and postmarketing cohort studies and discuss their safety, efficacy, and limitations, in relation to anti‐TNF therapy, in optimizing the treatment outcomes.

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Section: Safety Of Ustekinumab In Special Populationsmentioning

confidence: 71%

“…Perioperative safety outcomes of patients exposed to ustekinumab were assessed in two retrospective multicenter cohort studies . Ustekinumab use was not observed, in both studies, to be associated with the increased risk of postoperative surgical site infection when compared with anti‐TNF‐treated patients.…”

Section: Ustekinumabmentioning

confidence: 99%

A review of vedolizumab and ustekinumab for the treatment of inflammatory bowel diseases

et al. 2018

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“…However, two systematic reviews and meta-analysis [27,28] did not find increased risks of postoperative complications with the use of vedolizumab when compared to either preoperative anti-TNF therapy or no biological therapy. Studies regarding the use of ustekinumab comparing with anti-TNF therapy also demonstrated no increase in the risk of postoperative complications [29,30].…”

Section: Biological Therapy and Surgerymentioning

confidence: 99%

Biological Therapy for Inflammatory Bowel Diseases: Screening Prior to Initiating and How to Proceed When Surgery Is Necessary

Ayrizono¹,

Oliveira²,

Fagundes³

2020

Biological Therapy for Inflammatory Bowel Disease

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Biological therapy has revolutionized the management of inflammatory bowel disease (IBD) in the last 30 years. However, these drugs have side effects and adverse events. Before starting this therapy, it is necessary to screen for specific infectious diseases and monitoring protocols. Screening for human immunodeficiency virus, hepatitis C, hepatitis B, and Mycobacterium tuberculosis infections must be included. In addition, vaccination should be checked and updated if necessary. Despite the advent of biological therapy, a significant number of patients with IBD will need surgery in their lifetime due to either clinical intractability or disease complications. Many of them will be on biological therapy, and there is a considerable controversy about adverse effects of biologics on surgical outcomes. In this chapter, we will approach the screening required to start this therapy and how to proceed when surgery is necessary in these patients.

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“…There are minimal data on infectious risk with ustekinumab. A small retrospective study has shown that the 30‐day infectious complication rate after abdominal surgery for Crohn's disease in patients who received ustekinumab within 12 weeks prior to surgery was 13%, not dissimilar from patients who received anti‐TNF therapy .…”

Section: Impact Of Medication On Surgery For Ibdmentioning

confidence: 99%

The Association of Coloproctology of Great Britain and Ireland consensus guidelines in surgery for inflammatory bowel disease

et al. 2018

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Aim There is a requirement of an expansive and up to date review of surgical management of inflammatory bowel disease (IBD) that can dovetail with the medical guidelines produced by the British Society of Gastroenterology. Methods Surgeons who are members of the ACPGBI with a recognised interest in IBD were invited to contribute various sections of the guidelines. They were directed to produce a procedure based document using literature searches that were systematic, comprehensible, transparent and reproducible. Levels of evidence were graded. An editorial board was convened to ensure consistency of style, presentation and quality. Each author was asked to provide a set of recommendations which were evidence based and unambiguous. These recommendations were submitted to the whole guideline group and scored. They were then refined and submitted to a second vote. Only those that achieved >80% consensus at level 5 (strongly agree) or level 4 (agree) after 2 votes were included in the guidelines. Results All aspects of surgical care for IBD have been included along with 157 recommendations for management. Conclusion These guidelines provide an up to date and evidence based summary of the current surgical knowledge in the management of IBD and will serve as a useful practical text for clinicians performing this type of surgery.

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Postoperative Outcomes in Ustekinumab-Treated Patients Undergoing Abdominal Operations for Crohn’s Disease

Cited by 74 publications

References 23 publications

A review of vedolizumab and ustekinumab for the treatment of inflammatory bowel diseases

A review of vedolizumab and ustekinumab for the treatment of inflammatory bowel diseases

Biological Therapy for Inflammatory Bowel Diseases: Screening Prior to Initiating and How to Proceed When Surgery Is Necessary

The Association of Coloproctology of Great Britain and Ireland consensus guidelines in surgery for inflammatory bowel disease

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