Literature DB >> 31328222

Case-matched Comparison of Postoperative Outcomes Following Surgery for Inflammatory Bowel Disease After Exposure to Vedolizumab vs Other Biologics.

M Novello1, L Stocchi1, S R Steele1, S D Holubar1, L C Duraes1, H Kessler1, S Shawki1, L T Hull1.   

Abstract

BACKGROUND AND AIM: The effects of vedolizumab [VEDO] exposure on perioperative outcomes following surgery for inflammatory bowel disease [IBD] remain controversial. The aim of our study was to compare postoperative morbidity of IBD surgery following treatment with VEDO vs other biologics or no biologics.
METHODS: An institutional review board-approved, prospectively collected database was queried to identify all patients undergoing abdominal surgery for IBD between August 2012 and May 2017. The impact of VEDO within 12 weeks preoperatively on postoperative morbidity was initially assessed with univariate and multivariable analyses on all patients. A case-matched analysis was then carried out comparing patients exposed to VEDO vs other biologic agents, based on gender, age ± 5 years, diagnosis, date of surgery ± 2 years, and surgical procedure.
RESULTS: Out of 980 patients, 141 received VEDO. The majority of patients [59%] underwent surgery involving end or diverting ostomy creation. The initial multivariate analysis conducted on all patients indicated that VEDO use was independently associated with increased overall morbidity [p <0.001], but not infectious morbidity [p = 0.30]. However, the case-matched comparison of 95 VEDO-treated patients vs 95 patients treated with adalimumab or infliximab did not indicate any difference in overall morbidity [p = 0.32], infectious complications [p = 0.15], or surgical site infections [p = 0.12].
CONCLUSIONS: In a study population having a high rate of surgery involving ostomy creation, the exposure to preoperative VEDO was not associated with an increased morbidity rate when compared with other biologics. Published by Oxford University Press on behalf of European Crohn’s and Colitis Organisation (ECCO) 2019.

Entities:  

Keywords:  Crohn’s disease; anti-TNFα; postoperative complications; postoperative infectious complications; surgery; ulcerative colitis; vedolizumab

Year:  2020        PMID: 31328222     DOI: 10.1093/ecco-jcc/jjz129

Source DB:  PubMed          Journal:  J Crohns Colitis        ISSN: 1873-9946            Impact factor:   9.071


  5 in total

Review 1.  Prehabilitation prior to intestinal resection in Crohn's disease patients: An opinion review.

Authors:  Michiel T J Bak; Marit F E Ruiterkamp; Oddeke van Ruler; Marjo J E Campmans-Kuijpers; Bart C Bongers; Nico L U van Meeteren; C Janneke van der Woude; Laurents P S Stassen; Annemarie C de Vries
Journal:  World J Gastroenterol       Date:  2022-06-14       Impact factor: 5.374

Review 2.  Reducing Perioperative Risks of Surgery in Crohn's Disease.

Authors:  Wolfgang Reindl; Anne Kerstin Thomann; Christian Galata; Peter Kienle
Journal:  Visc Med       Date:  2019-11-12

3.  Increased Risk of Infections with Anti-TNF Agents in Patients with Crohn's Disease After Elective Surgery: Meta-Analysis.

Authors:  Jurij Hanzel; Ahmed Almradi; Alexandra C Istl; Mei Lucy Yang; Katherine A Fleshner; Claire E Parker; Leonardo Guizzetti; Christopher Ma; Siddharth Singh; Vipul Jairath
Journal:  Dig Dis Sci       Date:  2021-02-26       Impact factor: 3.199

4.  Essential updates 2018/2019: Colorectal (benign): Recent updates (2018-2019) in the surgical treatment of benign colorectal diseases.

Authors:  Takayuki Ogino; Tsunekazu Mizushima; Chu Matsuda; Masaki Mori; Yuichiro Doki
Journal:  Ann Gastroenterol Surg       Date:  2019-12-16

5.  Risk of postoperative infectious complications from medical therapies in inflammatory bowel disease.

Authors:  Cindy Cy Law; Conor Bell; Deborah Koh; Yueyang Bao; Vipul Jairath; Neeraj Narula
Journal:  Cochrane Database Syst Rev       Date:  2020-10-24
  5 in total

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