This article is more than 5 years old. Information may no longer be current.
Infliximab did not increase complication risk in UC patients undergoing abdominal surgery
Patients with ulcerative colitis who received infliximab before abdominal surgery were not at increased risk for early postoperative complications in a recent study.
Researchers performed a meta-analysis of 13 studies incorporating 2,933 patients with ulcerative colitis (UC) who either did (n=516) or did not (n=2,417) receive treatment with infliximab before their surgeries. Incidence of infectious and noninfectious complications after surgery was recorded, with a follow-up of 30 days in 10 studies and 60 days in two studies.
Among evaluable patients (494 treated and 2,298 controls), no association was found between postoperative complications and preoperative infliximab treatment (pooled OR=1.09, 0.87-1.37). Investigators also observed no associations between infliximab and either infectious (pooled OR=1.10, 0.51-2.38 for 265 treated patients and 721 controls across nine studies) or noninfectious complications (pooled OR=1.10, 0.76-1.59 for 243 treated patients and 602 controls for eight studies) specifically (95% CI for all). Significant heterogeneity was observed between the studies evaluating infectious complications (P=.002, I2=67%).
Among studies in which infliximab was administered within 12 weeks of surgery, the lack of association persisted between treatment and incidence of infectious (OR=0.89, 0.66-1.20 across six studies) and noninfectious complications (OR=1.16, 0.62-2.18 across three studies), and treatment within this period was significantly associated with decreased infection (OR=0.43, 0.22-0.83) (95% CI for all).
“Preoperative infliximab use does not increase the risk of early postoperative complications in patients with UC undergoing abdominal surgery,” the researchers concluded. “The current practice of some doctors to delay operation and to discontinue infliximab for 8-12 weeks prior to elective surgery in UC patients may not be warranted. A globally multicenter prospective study is required to confirm the findings of this meta-analysis.”