Anti-TNF Agents for Post-Op Recurrent Crohn's: To Switch or Not to Switch?
Adherence to the same anti-tumor-necrosis factor (TNF) agent seemed to be as effective as switching to a different anti-TNF agent for the treatment of post-operative recurrent Crohn's disease (CD)after the inception ileocolonic resection (ICR), study authors reported in the International Journal of Colorectal Disease.
Currently, there are no data or guidelines on whether the same anti-TNF agents or different anti-TNF agents preoperatively are preferred to treat post-op recurrence. Researchers from The Cleveland Clinic Foundation aimed to compare the efficacy of the consistent vs. switched anti-TNF strategies in patients with recurrent CD after their ICR.
The study included 85 patients with CD receiving anti-TNF agents prior to the inception ICR treated for clinical recurrence with either the same or different anti-TNF agents after resection. Study outcome was measured as the need for the subsequent resection of ileocolonic anastomosis (ICA) as calculated with survival curves.
The study cohort consisted of 42 patients in the consistent group and 43 in the switched group. During the median follow-up of 1.5 years, 7 patients in the consistent group and 8 patients in the switched group required the repeat resection of ICA. Study authors found similar results regarding subsequent resection of ICA-free survival (hazard ratio [HR] 1.36, 95% CI: 0.49–3.76; P=0.54) between the consistent and switched groups.
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