scholarly journals Infliximab Extends the Duration until the First Surgery in Patients with Crohn’s Disease

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Aki Sakatani ◽  
Mikihiro Fujiya ◽  
Takahiro Ito ◽  
Yuhei Inaba ◽  
Nobuhiro Ueno ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Abdominal Surgery ◽  
Univariate Analysis ◽  
Female Gender ◽  
Infliximab Treatment ◽  
Biological Drugs ◽  
History Of ◽  
Term Basis ◽  
Clinical Records

Background/Aims. While biological drugs are useful for relieving the disease activity and preventing abdominal surgery in patients with Crohn’s disease (CD), it is unclear whether the use of biological drugs in CD patients with no history of abdominal surgery is appropriate. We evaluated the effects of infliximab and other factors on extending the duration until the first surgery in CD patients on a long-term basis.Methods. The clinical records of 104 CD patients were retrospectively investigated. The cumulative nonoperation rate until the first surgery was examined with regard to demographic factors and treatments.Results. The 50% nonoperative interval in the 104 CD patients was 107 months. The results of a univariate analysis revealed that a female gender, the colitis type of CD, and the administration of corticosteroids, immunomodulators, or infliximab were factors estimated to improve the cumulative nonoperative rate. A multivariate analysis showed that the colitis type and administration of infliximab were independent factors associated with a prolonged interval until the first surgery in the CD patients with no history of abdominal surgery.Conclusions. This study suggests that infliximab treatment extends the duration until the first surgery in CD patients with no history of abdominal surgery. The early use of infliximab before a patient undergoes abdominal surgery is therefore appropriate.

scholarly journals Laparoscopic Redo Ileocolic Resection for Crohn’s Disease in Patients with Previous Multiple Laparotomies

2018 ◽  
Vol 108 (1) ◽  
pp. 42-48 ◽  
Author(s):  
V. Celentano ◽  
F. Sagias ◽  
K. G. Flashman ◽  
J. Conti ◽  
J. Khan
Keyword(s):  
Crohn’S Disease ◽  
Laparoscopic Surgery ◽  
Crohn's Disease ◽  
Abdominal Surgery ◽  
Conversion Rate ◽  
Operating Time ◽  
Ileocolic Resection ◽  
Short Term ◽  
Previous Abdominal Surgery ◽  
History Of

Purposes: Over 80% of patients with primary ileocolic Crohn’s disease have a surgical resection within 10 years of diagnosis, and 40%–50% of them need further surgery within 15 years. Laparoscopic surgery can be challenging due to a thickened mesentery and the potential for fistulas, abscesses, and phlegmons. Aim of this study is to analyze the short-term outcomes of laparoscopic redo ileocolic resections for Crohn’s disease in patients with previous multiple laparotomies. Methods: All patients undergoing laparoscopic surgery for ileocolic Crohn’s disease from March 2006 to February 2017 were prospectively evaluated. Short term outcomes of laparoscopic ileocolic resection were compared between patients with previous multiple major surgeries and recurrent Crohn’s disease, and patients undergoing surgery for the first presentation of Crohn’s disease and no history of previous surgery. Conversion rate and 30-day morbidity were the primary outcomes. Reoperations, readmissions, operating time and length of stay were the secondary outcomes. Results: 29 patients with recurrent Crohn’s disease and previous multiple laparotomies were included: the number of laparotomies these patients previously underwent was 2 in 19 cases (65.5%), 3 in 9 (31%), and 4 in 1 (3.5%). In total, 90 patients with no history of any previous abdominal surgery, who underwent laparoscopic ileocecal resection for Crohn’s disease, represented the control group. No differences were found in morbidity and conversion rate. Operating time was longer in patients with history of previous abdominal surgery. Conclusion: Laparoscopic redo ileocolic resection for Crohn’s disease is feasible and safe in patients with previous multiple laparotomies at the expense of longer operating time.

P218 Assessment of the degree of intestinal destruction in Crohn’s disease at the time of diagnosis

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S273-S274
Author(s):  
A Hassine ◽  
I Akkari ◽  
S Mrabet ◽  
E Ben Jazia
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Univariate Analysis ◽  
Biological Data ◽  
Bowel Injury ◽  
Age At Diagnosis ◽  
Duration Of Symptoms ◽  
Intestinal Lesions ◽  
History Of ◽  
The Mean

Abstract Background Certainly the presence of advanced intestinal lesions in Crohn’s disease (CD) is associated with a more frequent recourse to surgical resection. However, in general, the degree of intestinal destruction in patients with CD is not assessed at the time of diagnosis, and the natural history of CD may differ phenotypically from patient to patient. The aim of this study was to assess the degree of intestinal destruction in patients with CD at the time of diagnosis, using the Lemann Index (LI), and to identify the associated factors. Methods A retrospective study was conducted involving all patients with CD followed in our center over a period of 4 years (2016- 2020), and who were evaluated by endoscopy and MRI at baseline. The Lemann Index is a score that measures cumulative damage to digestive tissue from entero-MRI and endoscopy data. A LI score > 2.0 was set as a cutoff to define advanced bowel injury. Hypothesis tests were applied to identify associations. Results 112 patients with CD were included in this study, of which 53.6% were female. The mean age at diagnosis was 33.29 years [15–63]. Regarding the localization of CD, it was ileal, colonic, and ileocolonic in respectively 16.1%, 42.9% and 41%. The disease phenotype was inflammatory in 60.7%, stricturing in 21.42%, and penetrating in 17.85%. The initial flare was judged to be severe in 33.9%, moderate in 55.4% and mild in 10.7% of cases, with a mean CDAI of 305.21 [115–493]. 12 patients had already undergone bowel resection. As for the biological data, the mean value of C-Reactive Protein (CRP) at the time of diagnosis was 74.08 +/- 54.05 mg / l, and that of the sedimentation rate (ESR) was 62, 13 +/- 36.49 (the 1st hour). The mean LI was 3.14 (± 2.28) with 64 patients (57.1%) presenting an LI score indicating advanced bowel injury at diagnosis. In univariate analysis, the factors associated in a statistically significant way, with a more important Lemann Index were: the male sex (p = 0.037), the history of intestinal resection (p = 0.009), a severe initial flare (p = 0.049). Similarly, a strong correlation was observed with the initial CDAI score (p = 0.024, r = 0.05) and the initial value of ESR (p = 0.001, r = 0.01). In addition, the duration of symptoms, age at diagnosis, initial disease location and phenotype, presence or absence of anoperineal manifestations, and CRP value at diagnosis were not correlated to the degree of intestinal destruction according to the LI score, with respectively: p = 0.43, p = 0.12, p = 0.19, p = 0.49, p = 0.34 and p = 0.063. Conclusion In our series, advanced intestinal lesions are present at the time of diagnosis in a significant proportion of patients. Thus, the use of the Lemann score from the diagnosis of Crohn’s disease is necessary.

scholarly journals P563 Comparison of long-term outcomes of infliximab with adalimumab in biologic naïve patients with Crohn’s disease: a tertiary referral center 13-year experience

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S525-S526
Author(s):  
I Yuksel ◽  
M B Durak ◽  
V Kilic ◽  
F Kivrakoglu ◽  
K Kosar ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Abdominal Surgery ◽  
Age At Onset ◽  
Major Abdominal Surgery ◽  
Tertiary Referral ◽  
Tertiary Referral Center ◽  
Serious Infections ◽  
History Of

Abstract Background The comparative efficacy and safety of infliximab (IFX) and adalimumab (ADA) have shown variable results in biologic-naïve patients with Crohn’s disease (CD). Thus, long-term comparisons between IFX and ADA with or without immunomodulator therapies are still needed. The purpose of this study was to evaluate the long-term clinical effectiveness and safety profile of IFX compared to ADA in biologic-naïve patients with CD. Methods Data of all adult CD patients treated with IFX or ADA as their first biologic agent was collected retrospectively between December 2007 and February 2021. We compared CD-related hospitalization, CD-related major abdominal surgery, steroid use and serious infections leading to treatment cessation. Results Out of 224 biologic-naïve patients with CD, 101 started IFX first (median age at onset: 38.12 years, 61.4% male) and 123 started ADA first (median age at onset: 30.2 years, 64.2% male). Median disease duration was 6.94 years (IQR: 3.82–12.17) and 6.91 years (IQR: 3.94–10.95) for IFX and ADA, respectively, of whom 33% and 37.4% had active smokers, 10.9% and 13.4% had family history of inflammatory bowel disease (IBD) 22.8% and 19.5% had perianal disease, 43.6% and 43.9 had prior major abdominal surgery and 52.6% and 49.6% had extraintestinal manifestations. There were no significant differences between the two groups with respect to the age at onset of tumor necrosis factor antagonist, gender, smoking status, family history of IBD, perianal disease, prior major abdominal surgery, extraintestinal manifestations, prior immunomodulator (Thiopurine or Methotrexate) or steroid usage, all laboratory test results and Crohn’s Disease Activity Index (CDAI) score at baseline (p>0.05). Overall, the median follow-up time was 2.81 and 3.55 years after starting the first IFX and ADA group, respectively. There were no significant differences in the rate of steroid use (4% IFX vs. 10.6% ADA p=0.109), CD-related hospitalization (13.9% IFX vs. 22.8% ADA p=0.127), CD-related major abdominal surgery (9.9% IFX vs. 13% ADA p=0.608) and serious infections leading to treatment cessation (1% IFX vs 0.8% ADA p>0.999) between IFX and ADA. These outcomes were similar in patients treated with IFX or ADA monotherapy or in combination with an immunomodulator. Conclusion In this retrospective observational tertiary referral center study, we observed that there was no significant difference in long-term effectiveness and safety of infliximab and adalimumab in biologic-naïve patients with CD.

Transabdominal bowel sonography modifications in patients with active Crohn's disease before and after infliximab treatment

2001 ◽  
Vol 120 (5) ◽  
pp. A273-A273
Author(s):  
C SERRA ◽  
P GIONCHETTI ◽  
L VOLPE ◽  
C MORELLI ◽  
M CAMPIERI ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Infliximab Treatment ◽  
Before And After ◽  
Bowel Sonography

Long-Term Outcomes of Infliximab Treatment in 582 Korean Patients with Crohn’s Disease: A Hospital-Based Cohort Study

2016 ◽  
Vol 61 (7) ◽  
pp. 2060-2067 ◽  
Author(s):  
Sang Hyoung Park ◽  
Sung Wook Hwang ◽  
Min Seob Kwak ◽  
Wan Soo Kim ◽  
Jeong-Mi Lee ◽  
...  
Keyword(s):  
Cohort Study ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Infliximab Treatment ◽  
Long Term Outcomes ◽  
Korean Patients

scholarly journals Transperineal total mesorectal excision for rectal cancer on the residual rectum after multiple abdominal surgeries in a patient with Crohn’s disease: a case report

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Shin Emoto ◽  
Shigenori Homma ◽  
Tadashi Yoshida ◽  
Nobuki Ichikawa ◽  
Yoichi Miyaoka ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Intraoperative Complications ◽  
Rectal Stump ◽  
Stage I ◽  
Colonoscopic Examination ◽  
Case Presentation ◽  
History Of ◽  
Blood Loss Volume

Abstract Background The improved prognosis of Crohn’s disease may increase the opportunities of surgical treatment for patients with Crohn’s disease and the risk of development of colorectal cancer. We herein describe a patient with Crohn’s disease and a history of multiple surgeries who developed rectal stump carcinoma that was treated laparoscopically and transperineally. Case presentation A 51-year-old man had been diagnosed with Crohn’s disease 35 years earlier and had undergone several operations for treatment of Crohn’s colitis. Colonoscopic examination was performed and revealed rectal cancer at the residual rectum. The patient was then referred to our department. The tumor was diagnosed as clinical T2N0M0, Stage I. We treated the tumor by combination of laparoscopic surgery and concomitant transperineal resection of the rectum. While the intra-abdominal adhesion was dissected laparoscopically, rectal dissection in the correct plane progressed by the transperineal approach. The rectal cancer was resected without involvement of the resection margin. The duration of the operation was 3 h 48 min, the blood loss volume was 50 mL, and no intraoperative complications occurred. The pathological diagnosis of the tumor was type 5 well- and moderately differentiated adenocarcinoma, pT2N0, Stage I. No recurrence was evident 3 months after the operation, and no adjuvant chemotherapy was performed. Conclusion The transperineal approach might be useful in patients with Crohn’s disease who develop rectal cancer after multiple abdominal surgeries.

scholarly journals Effect of Originator Infliximab Treatment on Disease-Related Hospitalizations, Work Productivity and Activity Impairment, and Health Resource Utilization in Patients with Crohn’s Disease in a Real-Life Setting: Results of a Prospective Multicenter Study in Germany

2020 ◽  
pp. 1-13
Author(s):  
Niels Teich ◽  
Michael Bläker ◽  
Frank Holtkamp-Endemann ◽  
Eric Jörgensen ◽  
Andreas Stallmach ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Multicenter Study ◽  
Work Productivity ◽  
Infliximab Treatment ◽  
Prospective Multicenter Study ◽  
Hospitalization Rates ◽  
The Mean

<b><i>Introduction:</i></b> Infliximab (IFX) therapy is efficacious for inducing and maintaining symptomatic remission in patients with Crohn’s disease (CD), but whether this benefit results in reduced hospitalization rates and therefore may improve patients’ quality of life in an economically sensible way is conflicting so far. <b><i>Methods:</i></b> We conducted a noninterventional, multicenter, open-label, prospective study to evaluate the effect of originator IFX treatment on patient-reported outcomes and disease-related hospitalizations in adult CD patients in Germany treated for the first time with IFX according to label. <b><i>Results:</i></b> Two hundred and ninety-four patients were included in the study. We observed a statistically significant reduction in the number of CD-related hospitalizations from the year before baseline (mean 1.00 per patient, SD ± 0.93) to the mean value of the 1st (0.62, SD ± 0.95) and 2nd year (0.32, SD ± 0.75) of the observation period (<i>p</i> &#x3c; 0.0001). After 3 months of IFX therapy, work productivity and activity increased by an average of 12.6 and 17.1%, respectively. Patient’s clinical outcome was markedly improved as the total CD activity index (CDAI) sum score continuously decreased from baseline to month 24 and the mean score of the total inflammatory bowel disease questionnaire (IBDQ) changed substantially from 141 at baseline to 172 after 24 months of IFX treatment. Additionally, the number of work incapacity days declined. Recently, no new safety issues of IFX have been identified. <b><i>Conclusion:</i></b> In this large, prospective, multicenter study on disease-related hospitalization rates, work productivity, capacity for daily activities, and HRQoL in patients with CD, IFX significantly reduces their hospitalization rates and improves work productivity, daily activity, and quality of life over 24 months.

Sign in / Sign up

Export Citation Format

Share Document