Adalimumab or Infliximab for the Prevention of Early Postoperative Recurrence of Crohn Disease: Results From the ENEIDA Registry.

Autor:	Cañete F; Hospital Universitari Germans Trias i Pujol, Badalona, Catalonia, Spain.; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain.; Universitat Autònoma de Barcelona, Spain., Mañosa M; Hospital Universitari Germans Trias i Pujol, Badalona, Catalonia, Spain.; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain., Casanova MJ; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain.; Hospital de La Princesa, Madrid, Spain; Instituto de Investigación Sanitaria Princesa (IIS-IP), Universidad Autònoma de Madrid, Madrid, Spain., González-Sueyro RC; Hospital Clinic and IDIBAPS, Barcelona, Spain., Barrio J; Hospital Universitario Río Hortega, Valladolid, Spain., Bermejo F; Hospital Universitario de Fuenlabrada, and Instituto de Investigación Sanitaria IdiPaz, Madrid, Spain., Nos P; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain.; Hospital Universitario y Politécnico La Fe, Valencia, Spain., Iglesias-Flores E; Hospital Universitario Reina Sofía, Córdoba, Spain., García-Planella E; Hospital de La Santa Creu i Sant Pau; Barcelona, Spain., Pérez-Calle JL; Hospital Universitario Fundación Alcorcón, Madrid, Spain., Vicente R; Hospital Universitario Miguel Servet, Zaragoza, Spain., Vera M; Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain., Ramos L; Hospital Universitario de Canarias, Tenerife, Spain., Rivero M; Hospital Universitario Marqués de Valdecilla and IDIVAL, Santander, Spain., De Francisco R; Hospital Universitario Central de Asturias, Oviedo, Spain., Montserrat A; Consorci Corporació Sanitària Parc Taulí de Sabadell, Barcelona, Spain., Benítez O; Hospital Universitari Mútua Terrassa, Barcelona, Spain., Navarro P; Hospital Clínico Universitario de Valencia, Valencia, Spain., Taxonera C; Hospital Clínico San Carlos, Madrid, Spain., Hinojosa E; Hospital de Manises, Valencia, Spain., Márquez-Mosquera L; Hospital del Mar, Barcelona, Spain., Navarro-Llavat M; Hospital de Sant Joan Despí Moisès Broggi, Barcelona, Spain., Ramírez-de la Piscina P; Hospital Universitario de Álava, Vitoria-Gasteiz, Álava, Spain., Gomollón F; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain.; Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain., Rodríguez-Alonso L; Hospital Universitari De Bellvitge, Barcelona, Spain., Núñez-Alonso A; Hospital Universitario de Salamanca, Salamanca, Spain., Fernández-Salazar L; Hospital Clínico Universitario de Valladolid, Valladolid, Spain., Almela P; Hospital General Universitario de Castellón, Castellón, Spain., Ríos León R; Hospital Universitario Ramón y Cajal, Madrid, Spain., De Castro L; Complejo Hospitalario Universitario de Vigo, Vigo, Spain., Gisbert JP; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain.; Hospital de La Princesa, Madrid, Spain; Instituto de Investigación Sanitaria Princesa (IIS-IP), Universidad Autònoma de Madrid, Madrid, Spain., Ricart E; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain.; Hospital Clinic and IDIBAPS, Barcelona, Spain., Cabré E; Hospital Universitari Germans Trias i Pujol, Badalona, Catalonia, Spain.; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain., Domènech E; Hospital Universitari Germans Trias i Pujol, Badalona, Catalonia, Spain.; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain.
Jazyk:	angličtina
Zdroj:	Inflammatory bowel diseases [Inflamm Bowel Dis] 2019 Oct 18; Vol. 25 (11), pp. 1862-1870.
DOI:	10.1093/ibd/izz084
Abstrakt:	Background: Anti-tumor necrosis factor agents (anti-TNFs) are efficacious at preventing the postoperative recurrence (POR) of Crohn disease, as demonstrated in 2 randomized controlled trials. However, real-life data for infliximab or adalimumab in this setting are scarce. Our aim was to assess both the efficiency of anti-TNFs at preventing early POR of Crohn disease in clinical practice and the associated risk factors for POR. Methods: Patients in whom anti-TNFs were prescribed for the prevention of POR within 3 months after ileocolonic resection and who had an endoscopic assessment within 18 months were identified from the ENEIDA registry. Clinical and endoscopic features were collected within 18 months after surgery. Results: In total, 152 patients were included (55 treated with infliximab, 97 with adalimumab, and 39% with concomitant immunosuppressants). Anti-TNF treatment was started after a median time of 29 days (IQR 13-44) after surgery. Eighty-two percent of patients had at least one risk factor for POR, and 82% had been exposed to anti-TNFs before the index surgery. Overall, 34% had endoscopic POR (as defined using a Rutgeerts endoscopic score > i1); 14% had advanced endoscopic POR (>i2); and 20% had clinical POR, with no differences between infliximab and adalimumab. In the multivariate analysis, only perianal disease (odds ratio 2.73, 95% confidence interval [CI] 1.26-5.91) and rectal involvement (odds ratio 2.79, 95% CI 1.09-7.14) were independent predictors of endoscopic POR. Conclusions: In clinical practice, anti-TNFs for the prevention of POR of Crohn disease are frequently used in patients experienced with anti-TNFs and with concomitant immunosuppressants. The efficacy of infliximab and adalimumab for POR prevention is similar and in accordance with the results obtained in randomized controlled trials. (© 2019 Crohn’s & Colitis Foundation. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu