TY - JOUR
T1 - Adalimumab or Infliximab for the Prevention of Early Postoperative Recurrence of Crohn Disease: Results from the ENEIDA Registry
AU - Cañete, Fiorella
AU - Mañosa, Míriam
AU - Casanova, María José
AU - González-Sueyro, Ramiro C.
AU - Barrio, Jesús
AU - Bermejo, Fernando
AU - Nos, Pilar
AU - Iglesias-Flores, Eva
AU - García-Planella, Esther
AU - Pérez-Calle, José Lázaro
AU - Vicente, Raquel
AU - Vera, Maribel
AU - Ramos, Laura
AU - Rivero, Montserrat
AU - De Francisco, Ruth
AU - Montserrat, Antonia
AU - Benítez, Olga
AU - Navarro, Pablo
AU - Taxonera, Carlos
AU - Hinojosa, Esther
AU - Márquez-Mosquera, Lucía
AU - Navarro-Llavat, Mercé
AU - Ramírez-De La Piscina, Patricia
AU - Gomollón, Fernando
AU - Rodríguez-Alonso, Lorena
AU - Núñez-Alonso, Alejandro
AU - Fernández-Salazar, Luis
AU - Almela, Pedro
AU - Ríos León, Raquel
AU - De Castro, Luisa
AU - Gisbert, Javier P.
AU - Ricart, Elena
AU - Cabré, Eduard
AU - Domènech, Eugeni
N1 - © 2019 Crohn’s & Colitis Foundation. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: [email protected].
PY - 2019/4/22
Y1 - 2019/4/22
N2 - © 2019 Crohn's & Colitis Foundation. Published by Oxford University Press. All rights reserved. Anti-tumor necrosis factor agents (anti-TNFs) are efficacious at preventing the postoperative recurrence (POR) of Crohn disease, as demonstrated in 2 randomized controlled trials. However, real-life data for infliximab or adalimumab in this setting are scarce. Our aim was to assess both the efficiency of anti-TNFs at preventing early POR of Crohn disease in clinical practice and the associated risk factors for POR. Methods: Patients in whom anti-TNFs were prescribed for the prevention of POR within 3 months after ileocolonic resection and who had an endoscopic assessment within 18 months were identified from the ENEIDA registry. Clinical and endoscopic features were collected within 18 months after surgery. Results: In total, 152 patients were included (55 treated with infliximab, 97 with adalimumab, and 39% with concomitant immunosuppressants). Anti-TNF treatment was started after a median time of 29 days (IQR 13-44) after surgery. Eighty-two percent of patients had at least one risk factor for POR, and 82% had been exposed to anti-TNFs before the index surgery. Overall, 34% had endoscopic POR (as defined using a Rutgeerts endoscopic score > i1); 14% had advanced endoscopic POR (>i2); and 20% had clinical POR, with no differences between infliximab and adalimumab. In the multivariate analysis, only perianal disease (odds ratio 2.73, 95% confidence interval [CI] 1.26-5.91) and rectal involvement (odds ratio 2.79, 95% CI 1.09-7.14) were independent predictors of endoscopic POR. Conclusions: In clinical practice, anti-TNFs for the prevention of POR of Crohn disease are frequently used in patients experienced with anti-TNFs and with concomitant immunosuppressants. The efficacy of infliximab and adalimumab for POR prevention is similar and in accordance with the results obtained in randomized controlled trials.
AB - © 2019 Crohn's & Colitis Foundation. Published by Oxford University Press. All rights reserved. Anti-tumor necrosis factor agents (anti-TNFs) are efficacious at preventing the postoperative recurrence (POR) of Crohn disease, as demonstrated in 2 randomized controlled trials. However, real-life data for infliximab or adalimumab in this setting are scarce. Our aim was to assess both the efficiency of anti-TNFs at preventing early POR of Crohn disease in clinical practice and the associated risk factors for POR. Methods: Patients in whom anti-TNFs were prescribed for the prevention of POR within 3 months after ileocolonic resection and who had an endoscopic assessment within 18 months were identified from the ENEIDA registry. Clinical and endoscopic features were collected within 18 months after surgery. Results: In total, 152 patients were included (55 treated with infliximab, 97 with adalimumab, and 39% with concomitant immunosuppressants). Anti-TNF treatment was started after a median time of 29 days (IQR 13-44) after surgery. Eighty-two percent of patients had at least one risk factor for POR, and 82% had been exposed to anti-TNFs before the index surgery. Overall, 34% had endoscopic POR (as defined using a Rutgeerts endoscopic score > i1); 14% had advanced endoscopic POR (>i2); and 20% had clinical POR, with no differences between infliximab and adalimumab. In the multivariate analysis, only perianal disease (odds ratio 2.73, 95% confidence interval [CI] 1.26-5.91) and rectal involvement (odds ratio 2.79, 95% CI 1.09-7.14) were independent predictors of endoscopic POR. Conclusions: In clinical practice, anti-TNFs for the prevention of POR of Crohn disease are frequently used in patients experienced with anti-TNFs and with concomitant immunosuppressants. The efficacy of infliximab and adalimumab for POR prevention is similar and in accordance with the results obtained in randomized controlled trials.
KW - anti-TNFs
KW - Crohn disease
KW - postoperative recurrence
UR - http://www.mendeley.com/research/adalimumab-infliximab-prevention-early-postoperative-recurrence-crohn-disease-results-eneida-registr
UR - https://www.scopus.com/pages/publications/85073577867
U2 - 10.1093/ibd/izz084
DO - 10.1093/ibd/izz084
M3 - Article
C2 - 31006801
SN - 1078-0998
VL - 25
SP - 1862
EP - 1870
JO - Inflammatory Bowel Diseases
JF - Inflammatory Bowel Diseases
IS - 11
ER -