Disease recurrence in patients with Crohn’s disease after biologic therapy or surgery: a meta-analysis
Background Relapse is a problem in patients with Crohn’s disease (CD) after medical therapy (including biologics) and after surgery to treat acute inflammation. It is unclear whether the recurrence rate over time is higher after surgical therapy than after continuous drug treatment. Aim We sought to...
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| Veröffentlicht in: | International journal of colorectal disease 2022-10, Vol.37 (10), p.2185-2195 |
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| container_title | International journal of colorectal disease |
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| creator | Kneißl, Sarah Stallhofer, Johannes Schlattmann, Peter Stallmach, Andreas |
| description | Background
Relapse is a problem in patients with Crohn’s disease (CD) after medical therapy (including biologics) and after surgery to treat acute inflammation. It is unclear whether the recurrence rate over time is higher after surgical therapy than after continuous drug treatment.
Aim
We sought to compare clinical relapse rates and the need for re-interventions (resection or therapeutic endoscopic intervention) in patients with CD.
Methods
A meta-analysis was performed according to PRISMA guidelines.
Results
The need for re-intervention with medication or surgery due to surgical or clinical recurrence increased over time. The recurrence rates in patients after ileocecal resection were lower than the rates under biologic therapy. The odds ratio for clinical recurrence under biologics versus after surgical treatment was 2.50 (95% confidence interval [
CI
] 1.53–4.08,
p
-value |
| doi_str_mv | 10.1007/s00384-022-04254-z |
| format | Article |
| fullrecord | <record><control><sourceid>gale_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_9560971</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A722343876</galeid><sourcerecordid>A722343876</sourcerecordid><originalsourceid>FETCH-LOGICAL-c541t-83d8d5118ba76e088f006cac9aafb5b4411248fc674ba4a3c85d5019c8ea2afe3</originalsourceid><addsrcrecordid>eNp9ks1u1DAUhS0EokPhBVggS2zYpNiOk9gskKrhV6rEBtbWjXMzcZXYg52Apiteg9fjSfAwQ0sRQl5Y9v3usc71IeQxZ2ecseZ5YqxUsmBCFEyKShZXd8iKy1IUXNTiLlkx3uiC60qdkAcpXbJ8rht5n5yUNZdaymZFhlcuISSkEe0SI3qL1Hm6hdmhnxP96uaBrmMY_I9v3xPtjjT0M0baujCGjbN0HjDCdkdDpGmJG4y7FxTohDMU4GHcJZcekns9jAkfHfdT8unN64_rd8XFh7fv1-cXha0knwtVdqqrOFctNDUypXrGagtWA_Rt1UrJuZCqt9lHCxJKq6quYlxbhSCgx_KUvDzobpd2ws5mFxFGs41ugrgzAZy5XfFuMJvwxeiqZrrhWeDZUSCGzwum2UwuWRxH8BiWZESTp6iFFiyjT_9CL8MSs-E9JWStNZf8htrAiMb5PuR37V7UnDdClLJUTZ2ps39QeXU4ORs89i7f32oQhwYbQ0oR-2uPnJl9PswhHybnw_zKh7nKTU_-nM51y-9AZKA8ACmXfP7JG0v_kf0J0OTIGQ</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2724699141</pqid></control><display><type>article</type><title>Disease recurrence in patients with Crohn’s disease after biologic therapy or surgery: a meta-analysis</title><source>MEDLINE</source><source>Springer Nature - Complete Springer Journals</source><creator>Kneißl, Sarah ; Stallhofer, Johannes ; Schlattmann, Peter ; Stallmach, Andreas</creator><creatorcontrib>Kneißl, Sarah ; Stallhofer, Johannes ; Schlattmann, Peter ; Stallmach, Andreas</creatorcontrib><description>Background
Relapse is a problem in patients with Crohn’s disease (CD) after medical therapy (including biologics) and after surgery to treat acute inflammation. It is unclear whether the recurrence rate over time is higher after surgical therapy than after continuous drug treatment.
Aim
We sought to compare clinical relapse rates and the need for re-interventions (resection or therapeutic endoscopic intervention) in patients with CD.
Methods
A meta-analysis was performed according to PRISMA guidelines.
Results
The need for re-intervention with medication or surgery due to surgical or clinical recurrence increased over time. The recurrence rates in patients after ileocecal resection were lower than the rates under biologic therapy. The odds ratio for clinical recurrence under biologics versus after surgical treatment was 2.50 (95% confidence interval [
CI
] 1.53–4.08,
p
-value < 0.001). The odds ratio for surgical recurrence under biologics versus after surgery was 3.60 (95%
CI
1.06–12.3,
p
-value 0.041).
Conclusion
These findings support surgical resection as a treatment option in patients with CD with limited disease.</description><identifier>ISSN: 0179-1958</identifier><identifier>ISSN: 1432-1262</identifier><identifier>EISSN: 1432-1262</identifier><identifier>DOI: 10.1007/s00384-022-04254-z</identifier><identifier>PMID: 36149447</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Adalimumab ; Analysis ; Biological products ; Biological Products - therapeutic use ; Biological Therapy ; Cecum ; Crohn Disease - drug therapy ; Crohn Disease - surgery ; Crohn's disease ; Diseases ; Gastroenterology ; Health aspects ; Hepatology ; Humans ; Infliximab - therapeutic use ; Internal Medicine ; Medicine ; Medicine & Public Health ; Meta-analysis ; Monoclonal antibodies ; Patients ; Proctology ; Recurrence ; Relapse ; Surgery ; TNF inhibitors ; Treatment Outcome</subject><ispartof>International journal of colorectal disease, 2022-10, Vol.37 (10), p.2185-2195</ispartof><rights>The Author(s) 2022. corrected publication 2022</rights><rights>2022. The Author(s).</rights><rights>COPYRIGHT 2022 Springer</rights><rights>The Author(s) 2022. corrected publication 2022. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>The Author(s) 2022</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c541t-83d8d5118ba76e088f006cac9aafb5b4411248fc674ba4a3c85d5019c8ea2afe3</citedby><cites>FETCH-LOGICAL-c541t-83d8d5118ba76e088f006cac9aafb5b4411248fc674ba4a3c85d5019c8ea2afe3</cites><orcidid>0000-0002-6101-5244</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00384-022-04254-z$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00384-022-04254-z$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,314,776,780,881,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36149447$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kneißl, Sarah</creatorcontrib><creatorcontrib>Stallhofer, Johannes</creatorcontrib><creatorcontrib>Schlattmann, Peter</creatorcontrib><creatorcontrib>Stallmach, Andreas</creatorcontrib><title>Disease recurrence in patients with Crohn’s disease after biologic therapy or surgery: a meta-analysis</title><title>International journal of colorectal disease</title><addtitle>Int J Colorectal Dis</addtitle><addtitle>Int J Colorectal Dis</addtitle><description>Background
Relapse is a problem in patients with Crohn’s disease (CD) after medical therapy (including biologics) and after surgery to treat acute inflammation. It is unclear whether the recurrence rate over time is higher after surgical therapy than after continuous drug treatment.
Aim
We sought to compare clinical relapse rates and the need for re-interventions (resection or therapeutic endoscopic intervention) in patients with CD.
Methods
A meta-analysis was performed according to PRISMA guidelines.
Results
The need for re-intervention with medication or surgery due to surgical or clinical recurrence increased over time. The recurrence rates in patients after ileocecal resection were lower than the rates under biologic therapy. The odds ratio for clinical recurrence under biologics versus after surgical treatment was 2.50 (95% confidence interval [
CI
] 1.53–4.08,
p
-value < 0.001). The odds ratio for surgical recurrence under biologics versus after surgery was 3.60 (95%
CI
1.06–12.3,
p
-value 0.041).
Conclusion
These findings support surgical resection as a treatment option in patients with CD with limited disease.</description><subject>Adalimumab</subject><subject>Analysis</subject><subject>Biological products</subject><subject>Biological Products - therapeutic use</subject><subject>Biological Therapy</subject><subject>Cecum</subject><subject>Crohn Disease - drug therapy</subject><subject>Crohn Disease - surgery</subject><subject>Crohn's disease</subject><subject>Diseases</subject><subject>Gastroenterology</subject><subject>Health aspects</subject><subject>Hepatology</subject><subject>Humans</subject><subject>Infliximab - therapeutic use</subject><subject>Internal Medicine</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Meta-analysis</subject><subject>Monoclonal antibodies</subject><subject>Patients</subject><subject>Proctology</subject><subject>Recurrence</subject><subject>Relapse</subject><subject>Surgery</subject><subject>TNF inhibitors</subject><subject>Treatment Outcome</subject><issn>0179-1958</issn><issn>1432-1262</issn><issn>1432-1262</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>EIF</sourceid><recordid>eNp9ks1u1DAUhS0EokPhBVggS2zYpNiOk9gskKrhV6rEBtbWjXMzcZXYg52Apiteg9fjSfAwQ0sRQl5Y9v3usc71IeQxZ2ecseZ5YqxUsmBCFEyKShZXd8iKy1IUXNTiLlkx3uiC60qdkAcpXbJ8rht5n5yUNZdaymZFhlcuISSkEe0SI3qL1Hm6hdmhnxP96uaBrmMY_I9v3xPtjjT0M0baujCGjbN0HjDCdkdDpGmJG4y7FxTohDMU4GHcJZcekns9jAkfHfdT8unN64_rd8XFh7fv1-cXha0knwtVdqqrOFctNDUypXrGagtWA_Rt1UrJuZCqt9lHCxJKq6quYlxbhSCgx_KUvDzobpd2ws5mFxFGs41ugrgzAZy5XfFuMJvwxeiqZrrhWeDZUSCGzwum2UwuWRxH8BiWZESTp6iFFiyjT_9CL8MSs-E9JWStNZf8htrAiMb5PuR37V7UnDdClLJUTZ2ps39QeXU4ORs89i7f32oQhwYbQ0oR-2uPnJl9PswhHybnw_zKh7nKTU_-nM51y-9AZKA8ACmXfP7JG0v_kf0J0OTIGQ</recordid><startdate>20221001</startdate><enddate>20221001</enddate><creator>Kneißl, Sarah</creator><creator>Stallhofer, Johannes</creator><creator>Schlattmann, Peter</creator><creator>Stallmach, Andreas</creator><general>Springer Berlin Heidelberg</general><general>Springer</general><general>Springer Nature B.V</general><scope>C6C</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-6101-5244</orcidid></search><sort><creationdate>20221001</creationdate><title>Disease recurrence in patients with Crohn’s disease after biologic therapy or surgery: a meta-analysis</title><author>Kneißl, Sarah ; Stallhofer, Johannes ; Schlattmann, Peter ; Stallmach, Andreas</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c541t-83d8d5118ba76e088f006cac9aafb5b4411248fc674ba4a3c85d5019c8ea2afe3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Adalimumab</topic><topic>Analysis</topic><topic>Biological products</topic><topic>Biological Products - therapeutic use</topic><topic>Biological Therapy</topic><topic>Cecum</topic><topic>Crohn Disease - drug therapy</topic><topic>Crohn Disease - surgery</topic><topic>Crohn's disease</topic><topic>Diseases</topic><topic>Gastroenterology</topic><topic>Health aspects</topic><topic>Hepatology</topic><topic>Humans</topic><topic>Infliximab - therapeutic use</topic><topic>Internal Medicine</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Meta-analysis</topic><topic>Monoclonal antibodies</topic><topic>Patients</topic><topic>Proctology</topic><topic>Recurrence</topic><topic>Relapse</topic><topic>Surgery</topic><topic>TNF inhibitors</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kneißl, Sarah</creatorcontrib><creatorcontrib>Stallhofer, Johannes</creatorcontrib><creatorcontrib>Schlattmann, Peter</creatorcontrib><creatorcontrib>Stallmach, Andreas</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>International journal of colorectal disease</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kneißl, Sarah</au><au>Stallhofer, Johannes</au><au>Schlattmann, Peter</au><au>Stallmach, Andreas</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Disease recurrence in patients with Crohn’s disease after biologic therapy or surgery: a meta-analysis</atitle><jtitle>International journal of colorectal disease</jtitle><stitle>Int J Colorectal Dis</stitle><addtitle>Int J Colorectal Dis</addtitle><date>2022-10-01</date><risdate>2022</risdate><volume>37</volume><issue>10</issue><spage>2185</spage><epage>2195</epage><pages>2185-2195</pages><issn>0179-1958</issn><issn>1432-1262</issn><eissn>1432-1262</eissn><abstract>Background
Relapse is a problem in patients with Crohn’s disease (CD) after medical therapy (including biologics) and after surgery to treat acute inflammation. It is unclear whether the recurrence rate over time is higher after surgical therapy than after continuous drug treatment.
Aim
We sought to compare clinical relapse rates and the need for re-interventions (resection or therapeutic endoscopic intervention) in patients with CD.
Methods
A meta-analysis was performed according to PRISMA guidelines.
Results
The need for re-intervention with medication or surgery due to surgical or clinical recurrence increased over time. The recurrence rates in patients after ileocecal resection were lower than the rates under biologic therapy. The odds ratio for clinical recurrence under biologics versus after surgical treatment was 2.50 (95% confidence interval [
CI
] 1.53–4.08,
p
-value < 0.001). The odds ratio for surgical recurrence under biologics versus after surgery was 3.60 (95%
CI
1.06–12.3,
p
-value 0.041).
Conclusion
These findings support surgical resection as a treatment option in patients with CD with limited disease.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>36149447</pmid><doi>10.1007/s00384-022-04254-z</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0002-6101-5244</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0179-1958 |
| ispartof | International journal of colorectal disease, 2022-10, Vol.37 (10), p.2185-2195 |
| issn | 0179-1958 1432-1262 1432-1262 |
| language | eng |
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| source | MEDLINE; Springer Nature - Complete Springer Journals |
| subjects | Adalimumab Analysis Biological products Biological Products - therapeutic use Biological Therapy Cecum Crohn Disease - drug therapy Crohn Disease - surgery Crohn's disease Diseases Gastroenterology Health aspects Hepatology Humans Infliximab - therapeutic use Internal Medicine Medicine Medicine & Public Health Meta-analysis Monoclonal antibodies Patients Proctology Recurrence Relapse Surgery TNF inhibitors Treatment Outcome |
| title | Disease recurrence in patients with Crohn’s disease after biologic therapy or surgery: a meta-analysis |
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