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Anti-TNF therapy, immunomodulators led to similar complication rates in IBD patients

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SAN DIEGO — Patients with IBD who undergo anti-tumor necrosis factor therapy are no more likely to experience early postoperative complications following intestinal resection than patients on immunomodulators alone, according to data presented at the 2012 Digestive Disease Week Annual Meeting.

Researchers performed a retrospective review of 114 patients with IBD who underwent intestinal resection between July 2005 and July 2010. Investigators compared data from patients undergoing anti-tumor necrosis factor (TNF) therapy (n=76) to those who received immunomodulators. The anti-TNF patients were further divided into remote preoperative (RP) (n=30) and immediate preoperative (IP) (n=46) groups, which included patients who received a preoperative TNF dose greater than (RP) or less than (IP) one-half of their dosing intervals. The rate of early postoperative complication (EPC) such as infection, readmission, reoperation, thrombosis or acute kidney injury was the primary evaluated factor.

Patients who underwent anti-TNF therapy were not found significantly more likely to experience EPC than immunomodulator patients (43.4% vs. 26.3%, P=.08). There also was no significant difference in EPC rate between the IP and RP groups (21.7% vs. 30.0%, P=.16). Researchers found that more anti-TNF patients were on steroids than immunomodulator patients (43.4% vs. 18.4%, P=.001), but steroid use was not associated with a change in EPC rate or length of hospital stay.

“The anti-TNF group … had slightly more aggressive disease on average compared to the immunomodulator group, and also had more steroids on board, so you would have predicted them to have done worse postoperatively than the immunomodulator group, but they fared about the same,” researcher Daniel J. Stein, MD, Medical College of Wisconsin, Milwaukee, told Healio.com. “Anti-TNF therapy is safe in the setting of intestinal resection for IBD patients and should not be withheld, mainly because any breaks in anti-TNF therapy render them less effective over time.”

For more information:

Desai PN. #Su1560: Timing of Pre-Operative Anti-Tumor Necrosis Factor Therapy Does Not Affect Early Post-Operative Complication Rates in Inflammatory Bowel Disease Patients Undergoing Intestinal Resection. Presented at: the 2012 Digestive Disease Week Annual Meeting; May 19-22, San Diego.