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학술저널
저자정보
Sakiko Hiraoka (Okayama University Graduate School of Medicine) Shiho Takashima (Okayama University Graduate School of Medicine) Yoshitaka Kondo (Okayama University Graduate School of Medicine) Toshihiro Inokuchi (Okayama University Graduate School of Medicine) Yuusaku Sugihara (Okayama University Graduate School of Medicine) Masahiro Takahara (Okayama University Graduate School of Medicine) Seiji Kawano (Okayama University Graduate School of Medicine) Keita Harada (Okayama University Graduate School of Medicine) Wakayama Medical University (Wakayama Medical University) Hiroyuki Okada (Okayama University Graduate School of Medicine)
저널정보
대한장연구학회 Intestinal research Intestinal research Vol.16 No.1
발행연도
2018.1
수록면
75 - 82 (8page)

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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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