Impact of Biological Agents on Postsurgical Complications in Inflammatory Bowel Disease

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 retrospe...

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Autores: García García, María José|||0000-0002-6517-7005, Rivero, Montserrat|||0000-0002-5834-1559, Miranda Bautista, José, Bastón Rey, Iria, Mesonero, Francisco|||0000-0002-7864-8187, Leo Carnerero, Eduardo|||0000-0002-1267-5211, Casas Deza, Diego|||0000-0001-6883-8940, Cagigas Fernández, Carmen|||0000-0002-1675-5120, Martín Cardona, Albert|||0000-0002-7090-0106, El Hajra, Ismael, Hernández Aretxabaleta, Nerea, Pérez Martínez, Isabel, Fuentes Valenzuela, Esteban, Jiménez, Nuria, Rubín de Célix, Cristina|||0000-0003-3611-8994, Gutiérrez Casbas, Ana|||0000-0002-5460-4139, Suárez Ferrer, Cristina|||0000-0003-1789-3784, Huguet, José María|||0000-0001-6486-1262, Fernández Clotet, Agnes|||0000-0001-7513-0764, González Vivó, María|||0000-0001-5857-3766, Del Val, Blanca, Castro Poceiro, Jesús, Melcarne, Luigi|||0000-0002-9718-9692, Dueñas, Carmen, Izquierdo, Marta, Monfort, David, Bouhmidi, Abdel, Ramírez de la Piscina, Patricia, Romero, Eva|||0000-0003-2563-8177, Molina, Gema, Zorrilla Ortúzar, J., Calvino Suárez, Cristina, Sánchez, Eugenia|||0000-0001-9771-7865, Nuñez, Andrea, Sierra, Olivia, Castro, Beatriz, Zabana, Yamile|||0000-0003-4023-8868, González Partida, Irene, De la Maza, Saioa, Castaño-García, Andrés|||0000-0002-7921-9026, Nájera Muñoz, Rodrigo, Sánchez Guillén, Luis|||0000-0003-0623-9074, Riat Castro, Micaela, Rueda, José Luis, Benítez, José Manuel|||0000-0001-8898-3141, Delgado Guillena, Pedro, Tardillo, Carlos, Peña, Elena, Frago Larramona, Santiago, Rodríguez Grau, María Carmen, Plaza, Rocío, Pérez Galindo, Pablo, Martínez Cadilla, Jesús|||0000-0002-8091-9433, Menchén, Luis, Barreiro de-Acosta, Manuel|||0000-0001-5915-1477, Sánchez Aldehuelo, Rubén|||0000-0002-7597-5596, De la Cruz, María Dolores, Lamuela, Luis Javier, Marín Jiménez, Ignacio|||0000-0001-5424-2484, Nieto García, Laura, López San Román, Antonio|||0000-0003-0236-4118, Herrera, José Manuel, Chaparro, María|||0000-0002-9275-4242, P. Gisbert, Javier|||0000-0003-2090-3445
Tipo de recurso: artículo
Fecha de publicación:2021
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:290154
Acceso en línea:https://ddd.uab.cat/record/290154
https://dx.doi.org/urn:doi:10.3390/jcm10194402
Access Level:acceso abierto
Palabra clave:Anti-TNF
Crohn's disease
Inflammatory bowel disease
Postoperative complications
Preoperative therapy
Surgery
Ulcerative colitis
Ustekinumab
Vedolizumab
Descripción
Sumario: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.

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