Amelie Carla-Moreau1, Stephane Paul1, Xavier Roblin2, Christian Genin1, Laurent Peyrin-Biroulet3. 1. Department of Immunology, Saint-Etienne University Hospital, France. 2. Department of Gastroenterology, Saint-Etienne University Hospital, France. 3. Inserm U954 and Department of Gastroenterology, Nancy University Hospital, Lorraine University, France. Electronic address: peyrinbiroulet@gmail.com.
Abstract
BACKGROUND: The magnitude of the efficacy of anti-tumour necrosis factor (TNF) therapy in preventing and treating postoperative Crohn's disease recurrence has yet to be determined. METHODS: We searched MEDLINE, the Cochrane Library, and EMBASE. The primary endpoints, and clinical and endoscopic recurrence, were analysed using the Mantel-Haenszel and DerSimonian and Laird methods. RESULTS: Nine controlled trials (n=362) that evaluated the efficacy of anti-TNF therapy in preventing (n=7) or treating (n=2) postoperative recurrence were included. Anti-TNF therapy was more effective at preventing (n=6) endoscopic recurrence than the control arms (odds ratio 0.05; 95% confidence interval 0.02-0.13, P<0.0001; NNT=1.9). Anti-TNF therapy was more effective at preventing (n=5) clinical recurrence than the control arms (odds ratio 0.10; 95% confidence interval 0.05-0.21, P<0.0001; NNT=2.4). Anti-TNF therapy was more effective than control arms at treating endoscopic postoperative recurrence (n=2; odds ratio 16.64; 95% confidence interval 2.51-110.27, P<0.004; NNT=2.3). Neither heterogeneity nor publication bias was observed. CONCLUSION: Anti-TNF agents may be more effective in preventing clinical and endoscopic postoperative Crohn's disease recurrence than control treatment (thiopurines or mesalamine). Efficacy in treating postoperative Crohn's disease recurrence will require further investigation. Large randomised controlled trials are awaited.
BACKGROUND: The magnitude of the efficacy of anti-tumour necrosis factor (TNF) therapy in preventing and treating postoperative Crohn's disease recurrence has yet to be determined. METHODS: We searched MEDLINE, the Cochrane Library, and EMBASE. The primary endpoints, and clinical and endoscopic recurrence, were analysed using the Mantel-Haenszel and DerSimonian and Laird methods. RESULTS: Nine controlled trials (n=362) that evaluated the efficacy of anti-TNF therapy in preventing (n=7) or treating (n=2) postoperative recurrence were included. Anti-TNF therapy was more effective at preventing (n=6) endoscopic recurrence than the control arms (odds ratio 0.05; 95% confidence interval 0.02-0.13, P<0.0001; NNT=1.9). Anti-TNF therapy was more effective at preventing (n=5) clinical recurrence than the control arms (odds ratio 0.10; 95% confidence interval 0.05-0.21, P<0.0001; NNT=2.4). Anti-TNF therapy was more effective than control arms at treating endoscopic postoperative recurrence (n=2; odds ratio 16.64; 95% confidence interval 2.51-110.27, P<0.004; NNT=2.3). Neither heterogeneity nor publication bias was observed. CONCLUSION: Anti-TNF agents may be more effective in preventing clinical and endoscopic postoperative Crohn's disease recurrence than control treatment (thiopurines or mesalamine). Efficacy in treating postoperative Crohn's disease recurrence will require further investigation. Large randomised controlled trials are awaited.
Authors: Anthony Buisson; Stéphane Nancey; Luc Manlay; David T Rubin; Xavier Hebuterne; Benjamin Pariente; Mathurin Fumery; David Laharie; Xavier Roblin; Gilles Bommelaer; Bruno Pereira; Laurent Peyrin-Biroulet; Lucine Vuitton Journal: United European Gastroenterol J Date: 2021-05-05 Impact factor: 4.623
Authors: Christine A Schad; Bryce E Haac; Raymond K Cross; Ali Syed; Shumet Lonsako; Andrea C Bafford Journal: Dig Dis Sci Date: 2019-01-25 Impact factor: 3.487
Authors: Aya Hammami; Raida Harbi; Nour Elleuch; Khaled Ben Meddeb; Wafa Ben Ameur; Wafa Dahmani; Ahlem Braham; Salem Ajmi; Mehdi Ksiaa; Aida Ben Slama; Hanen Jaziri; Ali Jmaa Journal: Ther Adv Gastrointest Endosc Date: 2022-03-19
Authors: Anthony Buisson; Lisa Cannon; Konstantin Umanskiy; Roger D Hurst; Neil H Hyman; Atsushi Sakuraba; Joel Pekow; Sushila Dalal; Russell D Cohen; Bruno Pereira; David T Rubin Journal: Intest Res Date: 2021-08-04