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- Title
Effectiveness of Mesalazine, Thiopurines and Tumour Necrosis Factor Antagonists in Preventing Post-Operative Crohn's Disease Recurrence in a Real-Life Setting.
- Authors
allocca, Mariangela; Landi, Rosario; Bonovas, Stefanos; Fiorino, Gionata; Papa, alfredo; Spinelli, antonino; Furfaro, Federica; Peyrin-Biroulet, Laurent; armuzzi, alessandro; Danese, Silvio
- Abstract
Background: Most Crohn's disease (CD) patients develop endoscopic recurrence within one year of intestinal resection. The best treatment method to prevent post-operative CD recurrence remains uncertain. Methods: A total of 155 CD patients from 2 referral centres, who were undergoing intestinal resection with ileo-colonic anastomosis (January 2004-January 2015), were included. All subjects received preventive therapy with tumour necrosis factor antagonists (anti-TNFs), thiopurinesor mesalazine. The primary outcome was the rate of endoscopic recurrence (Rutgeerts score ≥ i2) in the 3 treatment groups. Results: Patients treated with anti- TNFs were at significantly lower risk of endoscopic recurrence during the follow-up than those receiving thiopurines or mesalazine (incidence rates of 2.2, 3.0 and 4.8 per 100 person-months, respectively, log-rank, p = 0.011). The median time to recurrence was significantly longer in patients treated with anti-TNFs than in those who received thiopurines or mesalazine (37.0, 13.7, and 16.8 months, respectively, log-rank, p = 0.011). Anti-TNFs were more effective than mesalazine (univariable analysis, hazard ratio [HR] 0.45, 95% CI 0.26-0.77, p = 0.004; multivariable analysis, HR 0.45, 95% CI 0.26-0.77, p = 0.004), and non-significantly superior over thiopurines. Conclusion: Anti-TNF therapy was the most effective strategy for the prevention of endoscopic CD recurrence.
- Subjects
MESALAMINE; TUMOR necrosis factors; TUMOR necrosis factor regulation; CROHN'S disease; DISEASE relapse; PREVENTION; TUMOR treatment; THERAPEUTICS
- Publication
Digestion, 2017, Vol 96, Issue 3, p166
- ISSN
0012-2823
- Publication type
Article
- DOI
10.1159/000480231