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Smoking, male sex linked to postoperative Crohn’s recurrence
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Researchers have identified associations between smoking, male sex and other factors with Crohn’s disease recurrence following ileocecal resection, according to a study published in Alimentary Pharmacology & Therapeutics.
Claire Auzolle, MD, of the University of Denis Diderot in Paris, and colleagues wrote that their findings could lead to changes in the way physicians manage patients with CD following surgery.
“Despite improvements in the medical management of [CD], more than twothirds of patients need intestinal resection,” they wrote. “Postoperative recurrence is frequently observed, and a preventive therapy is discussed in patients considered at risk.”
Investigators conducted a prospective study from 2010 to 2017 comprising 289 patients with CD from nine French academic centers (47% men; mean age 34.6 years). They collected data at the time of surgery and at an endoscopy performed 6months to 12 months after surgery.
Researchers determined that 70 patients were active smokers at the time of surgery (32%), and 142 received at least one anti-TNF therapy before surgery (63%).
Of 225 patients who completed follow-up endoscopy within one year of surgery, 107 experienced endoscopic recurrence (47%).
In their analysis, Auzolle and colleagues found that active smoking (OR = 2.65; 95% CI, 1.44–4.97), male sex (OR = 2.48; 95% CI, 1.4–4.46) and previous resection (OR = 3.03; 95% CI, 1.36–7.12) were all associated with a higher risk for endoscopic recurrence.
However, they also found that the anti-TNF treatment decreased the risk for endoscopic recurrence (OR = 0.5; 95% CI, 0.25–0.96).
Auzolle and colleagues wrote that several hormonal, genetic or behavioral factors — like diet — could be behind the higher risk for men.
“These data provide an important insight for clinical practice and may modify current algorithms of postoperative management,” they wrote. “A longterm followup of our cohort is needed to reinforce our findings.” – by Alex Young
Disclosures: Auzolle reports no relevant financial disclosures. Please see the full study for all other authors’ relevant financial disclosures.
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