Phenotypic Predictors of Endoscopic Recurrence after Ileal Resection for Crohn'S Disease: An Niddk IBD Genetics Consortium Prospective Study

Objective. To assess the benefits of different treatments that aim to prevent the endoscopic recurrence of Crohn’s disease (CD) after ileal resection. Methods. Randomized controlled trials (RCTs) were searched from MEDLINE, Embase, and the Cochrane Central Database. All the included RCTs with an endoscopic recurrence outcome which was defined as Rutgeerts’ score ≥ i2 have a duration of more than 1 year. The quality of the included RCTs was assessed by the Cochrane Risk of Bias Tool. Pairwise treatment effects were estimated through a Bayesian random effects network meta-analysis by using the OpenBUGS 1.4 software and reported as odds ratios (ORs) with a 95% credible interval (CI). Results. Fourteen RCTs (877 participants) were included. Two strategies were superior to placebo for preventing endoscopic recurrence of CD at 1 year after surgery: infliximab (d, −5.475; 95% CI, −10.47 to –1.632) and adalimumab (d, −7.273; 95% CI, −13.84 to −2.585). Nine strategies were not effective: budesnoid, mesalazine (in both high and low dose), azathioprine, Tripterygium wilfordii, mesalazine + infliximab, ornidazole, untreated intervention, and Lactobacillus GG. Conclusions. Except for infliximab and adalimumab, other strategies included in our analysis were not effective for preventing endoscopic recurrence of CD at 1 year after ileal resection.

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P389 Low-dose metronidazole is associated with a decreased rate of endoscopic recurrence of Crohn's disease after ileal resection

Journal of Crohn s and Colitis ◽

10.1093/ecco-jcc/jjx002.514 ◽

2017 ◽

Vol 11 (suppl_1) ◽

pp. S275-S275

Author(s):

L. Glick ◽

P.H. Sossenheimer ◽

A. Hirsch ◽

R.D. Hurst ◽

R.D. Cohen ◽

...

Keyword(s):

Crohn’S Disease ◽

Crohn's Disease ◽

Low Dose ◽

Ileal Resection ◽

Endoscopic Recurrence

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Low-Dose Metronidazole is Associated with a Decreased Rate of Endoscopic Recurrence of Crohn's Disease after Ileal Resection

Gastroenterology ◽

10.1016/s0016-5085(17)32687-2 ◽

2017 ◽

Vol 152 (5) ◽

pp. S774-S775

Author(s):

Laura Glick ◽

Philip H. Sossenheimer ◽

Ayal Hirsch ◽

Roger Hurst ◽

Russell D. Cohen ◽

...

Keyword(s):

Crohn’S Disease ◽

Crohn's Disease ◽

Low Dose ◽

Ileal Resection ◽

Endoscopic Recurrence

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DOP048. Predictors of post-operative endoscopic recurrence in Crohn's disease: a prospective study of the REMIND group

Journal of Crohn s and Colitis ◽

10.1093/ecco-jcc/jju027.076 ◽

2015 ◽

Vol 9 (suppl 1) ◽

pp. S51-S52

Keyword(s):

Crohn’S Disease ◽

Crohn's Disease ◽

Prospective Study ◽

Endoscopic Recurrence ◽

A Prospective Study

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P189. Serial monitoring of faecal calprotectin for the assessment of endoscopic recurrence in asymptomatic patients after ileocolonic resection for Crohn’s disease: a long-term prospective study

Journal of Crohn s and Colitis ◽

10.1093/ecco-jcc/jjw019.308 ◽

2016 ◽

Vol 10 (suppl 1) ◽

pp. S186.2-S186

Keyword(s):

Crohn’S Disease ◽

Crohn's Disease ◽

Prospective Study ◽

Faecal Calprotectin ◽

Endoscopic Recurrence ◽

Asymptomatic Patients ◽

Ileocolonic Resection

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Low-Dose Metronidazole is Associated With a Decreased Rate of Endoscopic Recurrence of Crohn’s Disease After Ileal Resection: A Retrospective Cohort Study

Journal of Crohn s and Colitis ◽

10.1093/ecco-jcc/jjz047 ◽

2019 ◽

Vol 13 (9) ◽

pp. 1158-1162 ◽

Cited By ~ 9

Author(s):

Laura R Glick ◽

Philip H Sossenheimer ◽

Jacob E Ollech ◽

Russell D Cohen ◽

Neil H Hyman ◽

...

Keyword(s):

Risk Factors ◽

Cohort Study ◽

Crohn’S Disease ◽

Crohn's Disease ◽

Retrospective Cohort ◽

Low Dose ◽

Primary Anastomosis ◽

Ileal Resection ◽

Endoscopic Recurrence ◽

Number Of Patients

Abstract Background and Aims Recurrence of Crohn’s disease after surgical resection and primary anastomosis is an important clinical challenge. Previous studies have demonstrated the benefit of imidazole antibiotics, but have been limited by adverse events and medication intolerance. We evaluated whether administration of low-dose metronidazole [250 mg three times per day] for 3 months reduces endoscopic postoperative recurrence rates. Methods We performed a retrospective cohort study of patients with Crohn’s disease who underwent ileal resection with a primary anastomosis and subsequently received care at our center. We compared the cases who received low-dose metronidazole for 3 months with control patients who did not receive this therapy. Data collected included demographics, risk factors for recurrence, and medications before and after surgery. The primary end point was the number of patients with ≥i2 [Rutgeerts] endoscopic recurrence by 12 months. Variables found to be predictive in univariate analysis at p < 0.10 were introduced in the Cox model for multivariate analysis. Results In all, 70 patients with Crohn’s disease [35 cases and 35 controls] met inclusion criteria. Risk factors for Crohn’s recurrence were similar between groups. The number of patients with ≥i2 endoscopic recurrence within 12 months following ileal resection was significantly lower in the metronidazole group [7 of 35 patients; 20%] compared with the number in the control group [19 of 35 patients; 54.3%] [p = 0.0058]. Eight participants [22.9%] in the metronidazole group experienced adverse events, and 3 of these patients [8.6%] discontinued the therapy. Conclusion Low-dose metronidazole reduces endoscopic recurrence of Crohn’s disease postoperatively and is well tolerated. This intervention should be considered as a therapy option following ileocolonic resection.

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