Vedolizumab does not increase perioperative surgical complications in patients with inflammatory bowel disease, cohort study

Abstract

gery have plateaued for both ulcerative colitis (UC) and Crohn' s disease (CD) while significant concerns have been raised about increasing rates of peri-operative complications. [2][3][4] Anti-tumor necrosis factor (anti-TNF) medications, in particular infliximab, have been shown to increase rates or perioperative infectious complications although this data remains controversial. 3,[8][9][10] It has also been suggested that concerns about anti-TNF related surgical complications is at least in part responsible for the increased rate of 3 stage surgery for UC in the United States. 10 Vedolizumab is an α4β7 anti-integrin antibody that has been increasingly used in both UC and CD. The α4β7 inhibi-

Which biologic agents increase perioperative complications in patients with inflammatory bowel disease?

“…10 In the multivariate analysis, the immunomodulator use or biologic agents were not associated with risk of perioperative complications. 10 The hypoalbuminemia ( < 3.6 g/dL) was the only significant risk factor associated with the risk of overall perioperative complications. 10 The short-term and long-term perioperative complication rates were low in patients treated with biologic agents within 4 weeks before surgery.…”

“…10 The hypoalbuminemia ( < 3.6 g/dL) was the only significant risk factor associated with the risk of overall perioperative complications. 10 The short-term and long-term perioperative complication rates were low in patients treated with biologic agents within 4 weeks before surgery. A prospective study with strong evidence is needed to overcome the controversy over the risk of perioperative complication risks on biologic agents.…”

“…The SSI at 30 days (7.9% vs. 7.4%) and 90 days (0% vs. 2.1%) complications were not different in patient treated with vedolizumab compared to patients treated with anti-TNF-α agents in this study [ 10 ]. In the multivariate analysis, the immunomodulator use or biologic agents were not associated with risk of perioperative complications [ 10 ]. The hypoalbuminemia ( < 3.6 g/dL) was the only significant risk factor associated with the risk of overall perioperative complications [ 10 ].…”

“…In the current issue, Poylin et al [ 10 ] reported the perioperative complication at both 30 days and 90 days in patients treated with vedolizumab (n = 38) and anti-TNF-α agents (n = 94) within 4 weeks of surgery to include higher biologic agent levels at the time of surgery. The SSI at 30 days (7.9% vs. 7.4%) and 90 days (0% vs. 2.1%) complications were not different in patient treated with vedolizumab compared to patients treated with anti-TNF-α agents in this study [ 10 ]. In the multivariate analysis, the immunomodulator use or biologic agents were not associated with risk of perioperative complications [ 10 ].…”

“…In the multivariate analysis, the immunomodulator use or biologic agents were not associated with risk of perioperative complications [ 10 ]. The hypoalbuminemia ( < 3.6 g/dL) was the only significant risk factor associated with the risk of overall perioperative complications [ 10 ].…”