Penetrating crohn disease is not associated ...
Document type :
Article dans une revue scientifique: Article original
PMID :
Permalink :
Title :
Penetrating crohn disease is not associated with a higher risk of recurrence after surgery: a prospective nationwide cohort conducted by the getaid chirurgie group
Author(s) :
Maggiori, Leon [Auteur]
Brouquet, Antoine [Auteur]
Zerbib, Philippe [Auteur]
Lefevre, Jeremie H. [Auteur]
Denost, Quentin [Auteur]
Germain, Adeline [Auteur]
Cotte, Eddy [Auteur]
Beyer-Berjot, Laura [Auteur]
Munoz-Bongrand, Nicolas [Auteur]
Desfourneaux, Veronique [Auteur]
Rahili, Amine [Auteur]
Duffas, Jean-Pierre [Auteur]
Pautrat, Karine [Auteur]
Denet, Christine [Auteur]
Bridoux, Valerie [Auteur]
Meurette, Guillaume [Auteur]
Faucheron, Jean-Luc [Auteur]
Loriau, Jerome [Auteur]
Souche, Regis [Auteur]
Vicaut, Eric [Auteur]
Panis, Yves [Auteur]
Benoist, Stephane [Auteur]
Histoire Archéologie Littératures des Mondes Anciens (HALMA) - UMR 8164
Brouquet, Antoine [Auteur]
Zerbib, Philippe [Auteur]

Lefevre, Jeremie H. [Auteur]
Denost, Quentin [Auteur]
Germain, Adeline [Auteur]
Cotte, Eddy [Auteur]
Beyer-Berjot, Laura [Auteur]
Munoz-Bongrand, Nicolas [Auteur]
Desfourneaux, Veronique [Auteur]
Rahili, Amine [Auteur]
Duffas, Jean-Pierre [Auteur]
Pautrat, Karine [Auteur]
Denet, Christine [Auteur]
Bridoux, Valerie [Auteur]
Meurette, Guillaume [Auteur]
Faucheron, Jean-Luc [Auteur]
Loriau, Jerome [Auteur]
Souche, Regis [Auteur]
Vicaut, Eric [Auteur]
Panis, Yves [Auteur]
Benoist, Stephane [Auteur]

Histoire Archéologie Littératures des Mondes Anciens (HALMA) - UMR 8164
Journal title :
Annals of Surgery
Abbreviated title :
Ann. Surg.
Publication date :
2019-09-16
ISSN :
1528-1140
English keyword(s) :
Crohn disease
risk factors
anti-TNF therapy
postoperative recurrence
risk factors
anti-TNF therapy
postoperative recurrence
HAL domain(s) :
Sciences du Vivant [q-bio]
English abstract : [en]
The aim of this study was to assess recurrence risk factors following ileocolonic resection (ICR) for Crohn disease (CD) in a nationwide cohort study SUMMARY BACKGROUND DATA:: Recurrence rate after ICR for CD can be up to ...
Show more >The aim of this study was to assess recurrence risk factors following ileocolonic resection (ICR) for Crohn disease (CD) in a nationwide cohort study SUMMARY BACKGROUND DATA:: Recurrence rate after ICR for CD can be up to 60%, but its predictive factors have never been evaluated in large prospective cohort studies. From 2013 to 2015, 346 consecutive patients undergoing ICR for CD and a postoperative ileocoloscopy within 6 to 12 months after surgery at 19 academic French centers were included prospectively. Twelve-month postoperative endoscopic (Rutgeerts score ≥i2) and clinical recurrence rates were 57.6% [95% confidence interval (CI), 54.2-61.0] and 11.3% (95% CI, 9-13.6), respectively. A total of 185 patients (54%) had a postoperative CD prophylaxis, comprising thiopurine in 69 (20%), or anti-tumor necrosis factor (TNF) therapy in 93 (27%). In multivariate Cox regression analysis, absence of postoperative smoking {odds ratio [OR] = 0.60 (95% CI, 0.40-0.91); P = 0.016}, postoperative prophylaxis [OR = 0.60 (95% CI, 0.41-0.88); P = 0.009], and penetrating disease behavior [OR = 0.58 (95% CI, 0.39-0.86); P = 0.007] were the only independent predictors of reduced endoscopic recurrence risk. Postoperative prophylaxis [OR 0.31 (95% CI, 0.15-0.66); P = 0.002), and penetrating behavior [OR = 00.36 (95% CI, 0.16-0.81); P = 0.013), were the only independent predictors of reduced clinical recurrence risk. Postoperative anti-TNF therapy was associated with a significant reduction of both 12-month risks of endoscopic (P < 0.001) and clinical (P = 0.019) recurrences. Absence of postoperative smoking, CD prophylaxis, and penetrating disease behavior could be independent predictors of reduced postoperative recurrence after ICR for CD. Prophylactic anti-TNF therapy reduces both endoscopic and clinical recurrence rates. It suggests that upfront surgery followed by postoperative anti-TNF therapy is probably the best therapeutic approach for complex CD (penetrating disease behavior).Show less >
Show more >The aim of this study was to assess recurrence risk factors following ileocolonic resection (ICR) for Crohn disease (CD) in a nationwide cohort study SUMMARY BACKGROUND DATA:: Recurrence rate after ICR for CD can be up to 60%, but its predictive factors have never been evaluated in large prospective cohort studies. From 2013 to 2015, 346 consecutive patients undergoing ICR for CD and a postoperative ileocoloscopy within 6 to 12 months after surgery at 19 academic French centers were included prospectively. Twelve-month postoperative endoscopic (Rutgeerts score ≥i2) and clinical recurrence rates were 57.6% [95% confidence interval (CI), 54.2-61.0] and 11.3% (95% CI, 9-13.6), respectively. A total of 185 patients (54%) had a postoperative CD prophylaxis, comprising thiopurine in 69 (20%), or anti-tumor necrosis factor (TNF) therapy in 93 (27%). In multivariate Cox regression analysis, absence of postoperative smoking {odds ratio [OR] = 0.60 (95% CI, 0.40-0.91); P = 0.016}, postoperative prophylaxis [OR = 0.60 (95% CI, 0.41-0.88); P = 0.009], and penetrating disease behavior [OR = 0.58 (95% CI, 0.39-0.86); P = 0.007] were the only independent predictors of reduced endoscopic recurrence risk. Postoperative prophylaxis [OR 0.31 (95% CI, 0.15-0.66); P = 0.002), and penetrating behavior [OR = 00.36 (95% CI, 0.16-0.81); P = 0.013), were the only independent predictors of reduced clinical recurrence risk. Postoperative anti-TNF therapy was associated with a significant reduction of both 12-month risks of endoscopic (P < 0.001) and clinical (P = 0.019) recurrences. Absence of postoperative smoking, CD prophylaxis, and penetrating disease behavior could be independent predictors of reduced postoperative recurrence after ICR for CD. Prophylactic anti-TNF therapy reduces both endoscopic and clinical recurrence rates. It suggests that upfront surgery followed by postoperative anti-TNF therapy is probably the best therapeutic approach for complex CD (penetrating disease behavior).Show less >
Language :
Anglais
Audience :
Internationale
Popular science :
Non
Administrative institution(s) :
CHU Lille
CNRS
Inserm
Ministère de la Culture
Université de Lille
CNRS
Inserm
Ministère de la Culture
Université de Lille
Collections :
Submission date :
2024-01-30T10:28:09Z