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

Adrienn Erős, N. Farkas, Péter Hegyi, Anikó Szabó, Márta Balaskó, G. Verès, László Czakó, J. Bajor, Hussain Alizadeh, Zoltán Rakonczay, Alexandra Mikó, Tamás Habon, Bálint Erőss, Bálint Bérczi, Patricia Sarlós

Research output: Review article

Abstract

Background: Despite the high rate of postoperative recurrence (POR) in Crohn's disease (CD), there is no widely accepted consensus on its prevention. Aim: To compare the efficacy of biological and conventional therapies in preventing POR of CD. Methods: 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. Results: 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. Conclusion: Anti-TNFα agents are more effective in preventing clinical, endoscopic and histological POR than conventional therapies, even in nonselected CD patients.

Original languageEnglish
Pages (from-to)1086-1095
Number of pages10
JournalDigestive and Liver Disease
Volume51
Issue number8
DOIs
Publication statusPublished - aug. 2019

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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