Adalimumab or Infliximab for the Prevention of Early Postoperative Recurrence of Crohn Disease: Results from the ENEIDA Registry

Fiorella Cañete, Míriam Mañosa, María José Casanova, Ramiro C. González-Sueyro, Jesús Barrio, Fernando Bermejo, Pilar Nos, Eva Iglesias-Flores, Esther García-Planella, José Lázaro Pérez-Calle, Raquel Vicente, Maribel Vera, Laura Ramos, Montserrat Rivero, Ruth De Francisco, Antonia Montserrat, Olga Benítez, Pablo Navarro, Carlos Taxonera, Esther HinojosaLucía Márquez-Mosquera, Mercé Navarro-Llavat, Patricia Ramírez-De La Piscina, Fernando Gomollón, Lorena Rodríguez-Alonso, Alejandro Núñez-Alonso, Luis Fernández-Salazar, Pedro Almela, Raquel Ríos León, Luisa De Castro, Javier P. Gisbert, Elena Ricart, Eduard Cabré, Eugeni Domènech

    Research output: Contribution to journalArticleResearch

    8 Citations (Scopus)

    Abstract

    © 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.
    Original languageEnglish
    Pages (from-to)1862-1870
    JournalInflammatory Bowel Diseases
    Volume25
    DOIs
    Publication statusPublished - 18 Oct 2019

    Keywords

    • anti-TNFs
    • Crohn disease
    • postoperative recurrence

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  • Cite this

    Cañete, F., Mañosa, M., Casanova, M. J., González-Sueyro, R. C., Barrio, J., Bermejo, F., Nos, P., Iglesias-Flores, E., García-Planella, E., Pérez-Calle, J. L., Vicente, R., Vera, M., Ramos, L., Rivero, M., De Francisco, R., Montserrat, A., Benítez, O., Navarro, P., Taxonera, C., ... Domènech, E. (2019). Adalimumab or Infliximab for the Prevention of Early Postoperative Recurrence of Crohn Disease: Results from the ENEIDA Registry. Inflammatory Bowel Diseases, 25, 1862-1870. https://doi.org/10.1093/ibd/izz084