Sistema de Salut de Catalunya
[García MJ, Rivero M] Gastroenterology Department, Hospital Universitario Marqués de Valdecilla, Universidad de Cantabria, Instituto de Investigación Sanitaria Valdecilla, Santander, Spain. [Miranda-Bautista J] Gastroenterology Department, Hospital Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, and Departamento de Medicina, Universidad Complutense, Madrid, Spain. [Bastón-Rey I] Gastroenterology Department, Hospital Universitario Clínico de Santiago, Santiago de Compostela, Spain. [Mesonero F] Gastroenterology Department, Hospital Universitario Ramón y Cajal, Madrid, Spain. [Leo-Carnerero E] Gastroenterology Department, Hospital Universitario Virgen del Rocío, Sevilla, Spain. [Monfort D] Servei de Digestologia, Hospital de Terrassa, Consorci Sanitari de Terrassa, Terrassa, Spain
Consorci Sanitari de Terrassa
2023-09-29T11:46:29Z
2023-09-29T11:46:29Z
2021-09-26
Crohn disease; Ustekinumab; Colitis, Ulcerative
Enfermedad de Crohn; Ustekinumab; Colitis ulcerosa
Malaltia de Crohn; Ustekinumab; Colitis ulcerosa
Background: The impact of biologics on the risk of postoperative complications (PC) in inflammatory bowel disease (IBD) is still an ongoing debate. This lack of evidence is more relevant for ustekinumab and vedolizumab. Aims: To evaluate the impact of biologics on the risk of PC. Methods: A retrospective study was performed in 37 centres. Patients treated with biologics within 12 weeks before surgery were considered "exposed". The impact of the exposure on the risk of 30-day PC and the risk of infections was assessed by logistic regression and propensity score-matched analysis. Results: A total of 1535 surgeries were performed on 1370 patients. Of them, 711 surgeries were conducted in the exposed cohort (584 anti-TNF, 58 vedolizumab and 69 ustekinumab). In the multivariate analysis, male gender (OR: 1.5; 95% CI: 1.2-2.0), urgent surgery (OR: 1.6; 95% CI: 1.2-2.2), laparotomy approach (OR: 1.5; 95% CI: 1.1-1.9) and severe anaemia (OR: 1.8; 95% CI: 1.3-2.6) had higher risk of PC, while academic hospitals had significantly lower risk. Exposure to biologics (either anti-TNF, vedolizumab or ustekinumab) did not increase the risk of PC (OR: 1.2; 95% CI: 0.97-1.58), although it could be a risk factor for postoperative infections (OR 1.5; 95% CI: 1.03-2.27). Conclusions: Preoperative administration of biologics does not seem to be a risk factor for overall PC, although it may be so for postoperative infections.
The authors report assistance from Equipo 3datos for the statistical analysis; this support was funded by the Spanish Working Group in Crohn’s Disease and Ulcerative Colitis (GETECCU).
Article
Published version
English
Crohn, Malaltia de; Colitis ulcerosa; Cirurgia; DISEASES::Digestive System Diseases::Gastrointestinal Diseases::Gastroenteritis::Inflammatory Bowel Diseases::Crohn Disease; CHEMICALS AND DRUGS::Amino Acids, Peptides, and Proteins::Proteins::Blood Proteins::Immunoproteins::Immunoglobulins::Antibodies::Antibodies, Monoclonal::Antibodies, Monoclonal, Humanized::Ustekinumab; DISEASES::Digestive System Diseases::Gastrointestinal Diseases::Gastroenteritis::Colitis::Colitis, Ulcerative; ENFERMEDADES::enfermedades del sistema digestivo::enfermedades gastrointestinales::gastroenteritis::enfermedad inflamatoria intestinal::enfermedad de Crohn; COMPUESTOS QUÍMICOS Y DROGAS::aminoácidos, péptidos y proteínas::proteínas::proteínas sanguíneas::inmunoproteínas::inmunoglobulinas::anticuerpos::anticuerpos monoclonales::anticuerpos monoclonales humanizados::ustekinumab; ENFERMEDADES::enfermedades del sistema digestivo::enfermedades gastrointestinales::gastroenteritis::colitis::colitis ulcerosa
MDPI
Journal of Clinical Medicine;10(19)
https://doi.org/10.3390/jcm10194402
Attribution 4.0 International
http://creativecommons.org/licenses/by/4.0/
