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Continued Postoperative Use of Tumor Necrosis Factor-α Inhibitors for the Prevention of Crohn's Disease Recurrence

Authors
 Jongwook Yu  ;  Hye Kyung Hyun  ;  Jihye Park  ;  Eun Ae Kang  ;  Soo Jung Park  ;  Jae Jun Park  ;  Tae Il Kim  ;  Won Ho Kim  ;  Jae Hee Cheon 
Citation
 GUT AND LIVER, Vol.16(3) : 414-422, 2022-05 
Journal Title
GUT AND LIVER
ISSN
 1976-2283 
Issue Date
2022-05
MeSH
Crohn Disease* / drug therapy ; Crohn Disease* / prevention & control ; Crohn Disease* / surgery ; Humans ; Postoperative Period ; Recurrence ; Retrospective Studies ; Tumor Necrosis Factor-alpha
Keywords
Crohn disease ; Postoperative recurrence ; Tumor necrosis factor-alpha inhibitor
Abstract
Background/aims: Many patients with Crohn's disease (CD) undergo intestinal resection during the disease course. Despite surgery, postoperative recurrence (POR) commonly occurs. Although postoperative use of tumor necrosis factor α (TNF-α) inhibitors is known to be effective in preventing POR, few studies have evaluated the effectiveness of continuing the same TNF-α inhibitors postoperatively in patients who received TNF-ɑ inhibitors before surgery.

Methods: This retrospective observational study was performed in a single tertiary medical center. We retrospectively reviewed patients who had undergone the first intestinal resection due to CD and divided them into two groups: TNF-α inhibitor users in both the preoperative and postoperative periods, and TNF-α inhibitor users in only the preoperative period. We compared the clinical outcomes between these two groups.

Results: In total, 45 patients who used TNF-α inhibitors preoperatively were recruited. Among them, TNF-α inhibitors were used postoperatively in 20 patients (44.4%). The baseline characteristics except age at diagnosis were similar in both groups. The rates of surgical and endoscopic recurrence were not different between the two groups, but the cumulative clinical recurrence rate was significantly lower in the postoperative TNF-α inhibitors group (log-rank p=0.003). In multivariate Cox regression analysis, postoperative TNF-α inhibitors use was significantly associated with a decreased risk of clinical recurrence (adjusted hazard ratio, 0.204; 95% confidence interval, 0.060 to 0.691; p=0.011).

Conclusions: Continuing TNF-α inhibitors postoperatively in patients who were receiving TNF-α inhibitors before surgery significantly reduced the rate of clinical recurrence. For patients with CD who received TNF-α inhibitors preoperatively, continuing their use after surgery could be recommended.
Files in This Item:
T202202186.pdf Download
DOI
10.5009/gnl210062
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Eun Ae(강은애)
Kim, Won Ho(김원호) ORCID logo https://orcid.org/0000-0002-5682-9972
Kim, Tae Il(김태일) ORCID logo https://orcid.org/0000-0003-4807-890X
Park, Soo Jung(박수정)
Park, Jae Jun(박재준)
Park, Ji Hye(박지혜)
Yu, Jongwook(유종욱)
Cheon, Jae Hee(천재희) ORCID logo https://orcid.org/0000-0002-2282-8904
Hyun, Hye Kyung(현혜경)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/189300
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