This article is more than 5 years old. Information may no longer be current.
No increased postoperative risks for Crohn’s disease patients who used presurgical anti-TNF-alpha agents
Patients who used anti-tumor necrosis factor-alpha agents within 12 weeks before intestinal resection for Crohn’s disease were not at significantly increased risk for postsurgical complications, according to study results.
Among a nationwide Danish cohort, researchers conducted an 8-year study of 2,293 surgical procedures performed for Crohn’s disease (CD). Patients who received anti-tumor necrosis factor-alpha (anti-TNF-a) therapy (57% infliximab) within 12 weeks before surgery were classified as exposed (n=214), and the remainder who did not use anti-TNF-a agents within 12 weeks presurgery composed the unexposed cohort (n=2,079). Researchers examined postsurgical outcomes for death, reoperation, anastomosis leakage, intra-abdominal abscess and bacteremia at 30 and 60 days.
Researchers determined there were no increased relative risks for death or abscess drainage at 30- and 60-day follow-up. Among the exposed cohort, 7.5% underwent reoperation within 30 days compared with 8.6% of the unexposed cohort (OR=0.92; 95% CI, 0.52-1.63). Anastomosis leakage occurred in 3.8% of the exposed patients and 2.8% of the unexposed cohort by 30 days (OR=1.33; 95% CI, 0.59-3.02).
Sub-analyses revealed that the relative risks for bacteremia among the exposed (1.5%) and unexposed (1.9%) at 30 days postsurgery were not significant (OR=0.79; 95% CI, 0.10-6.22); nor was risk increased at 30 and 60 days when anti-TNF-a agents were given within 14 days before surgery for reoperation (OR= 0.26; 95% CI, 0.4-1.97) or anastomosis leakage (OR=0.80; 95% CI, 0.10-6.23 within 30 days; OR=0.78; 95% CI, 0.10-6.03 within 60 days).
“This nationwide study showed no increased relative risks of death, reoperation, or abscess drainage 30 or 60 days after surgery among CD patients treated with anti-TNF-alpha agents within 12 weeks before surgery,” the researchers concluded. “As anti-TNF-alpha agent therapy has been introduced in recent years, it is of course especially important to monitor a possible negative effect on postoperative outcomes; thus, these first reassuring results should be confirmed in other settings.”