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

Adrienn Erős, N. Farkas, P. Hegyi, Anikó Szabó, M. Balaskó, Gábor Veres, L. Czakó, J. Bajor, Hussain Alizadeh, Z. 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
JournalDigestive and Liver Disease
DOIs
Publication statusPublished - jan. 1 2019

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Crohn Disease
Meta-Analysis
Recurrence
Biological Therapy
Biological Factors
Therapeutics
Placebos
Databases

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

Cite this

Anti-TNFα agents are the best choice in preventing postoperative Crohn's disease : A meta-analysis. / Erős, Adrienn; Farkas, N.; Hegyi, P.; Szabó, Anikó; Balaskó, M.; Veres, Gábor; Czakó, L.; Bajor, J.; Alizadeh, Hussain; Rakonczay, Z.; Mikó, Alexandra; Habon, Tamás; Erőss, Bálint; Bérczi, Bálint; Sarlós, Patricia.

In: Digestive and Liver Disease, 01.01.2019.

Research output: Review article

Erős, Adrienn ; Farkas, N. ; Hegyi, P. ; Szabó, Anikó ; Balaskó, M. ; Veres, Gábor ; Czakó, L. ; Bajor, J. ; Alizadeh, Hussain ; Rakonczay, Z. ; Mikó, Alexandra ; Habon, Tamás ; Erőss, Bálint ; Bérczi, Bálint ; Sarlós, Patricia. / Anti-TNFα agents are the best choice in preventing postoperative Crohn's disease : A meta-analysis. In: Digestive and Liver Disease. 2019.
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title = "Anti-TNFα agents are the best choice in preventing postoperative Crohn's disease: A meta-analysis",
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.",
keywords = "Adalimumab, Anti-TNFα, Crohn's disease, Infliximab, Postoperative recurrence, Preventive treatment",
author = "Adrienn Erős and N. Farkas and P. Hegyi and Anik{\'o} Szab{\'o} and M. Balask{\'o} and G{\'a}bor Veres and L. Czak{\'o} and J. Bajor and Hussain Alizadeh and Z. Rakonczay and Alexandra Mik{\'o} and Tam{\'a}s Habon and B{\'a}lint Erőss and B{\'a}lint B{\'e}rczi and Patricia Sarl{\'o}s",
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TY - JOUR

T1 - Anti-TNFα agents are the best choice in preventing postoperative Crohn's disease

T2 - A meta-analysis

AU - Erős, Adrienn

AU - Farkas, N.

AU - Hegyi, P.

AU - Szabó, Anikó

AU - Balaskó, M.

AU - Veres, Gábor

AU - Czakó, L.

AU - Bajor, J.

AU - Alizadeh, Hussain

AU - Rakonczay, Z.

AU - Mikó, Alexandra

AU - Habon, Tamás

AU - Erőss, Bálint

AU - Bérczi, Bálint

AU - Sarlós, Patricia

PY - 2019/1/1

Y1 - 2019/1/1

N2 - 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.

AB - 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.

KW - Adalimumab

KW - Anti-TNFα

KW - Crohn's disease

KW - Infliximab

KW - Postoperative recurrence

KW - Preventive treatment

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