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논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2018.1
- 수록면
- 75 - 82 (8page)
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초록· 키워드
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Background/Aims: The efficacy of anti-tumor necrosis factor α (anti-TNFα) antibodies for postoperative Crohn’s disease(CD) in patients who were treated with these agents prior to surgery is largely unknown. Methods: CD patients who underwentintestinal resection and received anti-TNFα agents after surgery were divided into 2 groups according to the presence orabsence of preoperative anti-TNFα treatment: anti-TNFα restart group or anti-TNFα naïve group. Endoscopic recurrence aftersurgery was examined according to the preoperative conditions, including administration of anti-TNFα agents before surgery. Results: Thirty-six patients received anti-TNFα antibody after surgery: 22 in the anti-TNFα restart group and 14 in the anti-TNFα naïve group. Endoscopic recurrence after surgery was more frequently observed in the anti-TNFα restart group than inthe anti-TNFα naïve group (68% vs. 14% , P <0.001). Multivariate analysis revealed the following significant risk factors of endoscopicrecurrence after surgery: anti-TNF restart group (odds ratio [OR], 28.10; 95% CI, 3.08−722.00), age at diagnosis <23 years(OR, 24.30; 95% CI, 1.67−1,312.00), serum albumin concentration at surgery <3.3 g/dL (OR, 34.10; 95% CI, 1.72–2,804.00), andpresence of inflammation outside of the surgical site (OR, 21.40; 95% CI, 1.02−2,150.00). Treatment intensification for patientswith endoscopic recurrence in the anti-TNFα restart group showed limited responses, with only 1 of 12 patients achieving endoscopicremission. Conclusions: The efficacy of restarting anti-TNFα antibody treatment after surgery was limited, and treatmentintensification or a change to different classes of biologics should be considered for those patients.
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참고문헌 (20)
참고문헌 신청
Steinhart AH / 1998 / Reliability of a Crohn's disease clinical classification scheme based on disease behavior / Inflamm Bowel Dis 4:228~234
Rutgeerts P / 2006 / Review article: recurrence of Crohn's disease after surgery-the need for treatment of new lesions / Aliment Pharmacol Ther 24(Suppl 3):29~32
Thia KT / 2010 / Risk factors associated with progression to intestinal complications of Crohn's disease in a population-based cohort / Gastroenterology 139:1147~1155
Frolkis AD / 2014 / Cumulative incidence of second intestinal resection in Crohn's disease: a systematic review and meta-analysis of population-based studies / Am J Gastroenterol 109:1739~1748
Paulo Gustavo Kotze / 2014 / Endoscopic Postoperative Recurrence Rates in Crohn’s Disease in Korea: The Beginning of a New Approach? / Intestinal research 12(3):258~259
Rutgeerts P / 2006 / Review article: recurrence of Crohn's disease after surgery-the need for treatment of new lesions / Aliment Pharmacol Ther 24(Suppl 3):29~32
Thia KT / 2010 / Risk factors associated with progression to intestinal complications of Crohn's disease in a population-based cohort / Gastroenterology 139:1147~1155
Frolkis AD / 2014 / Cumulative incidence of second intestinal resection in Crohn's disease: a systematic review and meta-analysis of population-based studies / Am J Gastroenterol 109:1739~1748
Paulo Gustavo Kotze / 2014 / Endoscopic Postoperative Recurrence Rates in Crohn’s Disease in Korea: The Beginning of a New Approach? / Intestinal research 12(3):258~259
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