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.
ASJC Scopus subject areas