AI Article Synopsis
- - The study investigates how effective biological therapies, specifically anti-TNFα agents, are in preventing postoperative recurrence (POR) of Crohn's disease compared to conventional treatments.
- - A comprehensive search of research articles was conducted, revealing that anti-TNFα therapies demonstrated significantly better outcomes in preventing various types of POR, including clinical and endoscopic recurrence.
- - The findings suggest that anti-TNFα agents like infliximab and adalimumab are more effective than conventional therapies in preventing POR in Crohn's disease patients, indicating a favorable option for treatment post-surgery.
Article Abstract
Background: Despite the high rate of postoperative recurrence (POR) in Crohn's disease (CD), there is no widely accepted consensus on its prevention.
Aim: To compare the efficacy of biological and conventional therapies in preventing POR of CD.
Methods: We searched four electronic databases up to April 2019 for articles that examined the efficacy of different preventive therapies against POR. Our PICO was: (P) adults with CD who underwent intestinal resection, (I) biological agents, (C) conventional therapies or a placebo, and (O) clinical, endoscopic, and histological POR.
Results: Anti-TNFα agents were significantly better in preventing clinical, endoscopic, severe endoscopic and histological POR compared to conventional therapies (OR: 0.508, 95% CI: 0.309-0.834, P = 0.007; OR: 0.312, 95% CI: 0.199-0.380, P < 0.001; OR: 0.195, 95% CI: 0.107-0.356, P < 0.001; and OR: 0.255, 95% CI: 0.106-0.611, P = 0.002, respectively), as well as in the subgroup of nonselected CD patients (OR: 0.324, 95% CI: 0.158-0.664, P = 0.002; OR: 0.225, 95% CI: 0.124-0.409, P < 0.001; and OR: 0.248, 95% CI: 0.070-0.877, P = 0.031, respectively). Infliximab and adalimumab proved to be equally effective in preventing endoscopic POR.
Conclusion: Anti-TNFα agents are more effective in preventing clinical, endoscopic and histological POR than conventional therapies, even in nonselected CD patients.
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| http://dx.doi.org/10.1016/j.dld.2019.05.027 | DOI Listing |
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