Anti-TNFα agents are the best choice in preventing postoperative Crohn's disease A meta-analysis /

Despite the high rate of postoperative recurrence (POR) in Crohn's disease (CD), there is no widely accepted consensus on its prevention.To compare the efficacy of biological and conventional therapies in preventing POR of CD.We searched four electronic databases up to April 2019 for articles t...

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Bibliographic Details
Main Authors: Erős Adrienn
Borbásné Farkas Kornélia
Hegyi Péter
Szabó Anikó Nóra
Balaskó Márta
Veres Gábor
Czakó László
Bajor Judit
Alizadeh Hussain
Rakonczay Zoltán, ifj
Mikó Alexandra
Habon Tamás
Erőss Bálint Mihály
Bérczi Bálint
Sarlós Patrícia
Format: Article
Published: 2019
Series:DIGESTIVE AND LIVER DISEASE 51 No. 8
doi:10.1016/j.dld.2019.05.027

mtmt:30734484
Online Access:http://publicatio.bibl.u-szeged.hu/18110
Description
Summary:Despite the high rate of postoperative recurrence (POR) in Crohn's disease (CD), there is no widely accepted consensus on its prevention.To compare the efficacy of biological and conventional therapies in preventing POR of CD.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.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.Anti-TNFα agents are more effective in preventing clinical, endoscopic and histological POR than conventional therapies, even in nonselected CD patients.
Physical Description:1086-1095
ISSN:1590-8658