Impact of Biological Agents on Postsurgical Complications in Inflammatory Bowel Disease: A Multicentre Study of Geteccu

Journal of Clinical Medicine

on behalf of the Young Group of GETECCU¹  Carmen Cagigas Fernández²  Luis Sánchez-Guillén³  Jaime Zorrilla⁴  Isabel Pérez-Martínez⁵  Andrés Castaño⁵  Pablo Pérez-Galindo⁶  Santiago Frago-Larramona⁷  David Monfort⁸  Gema Molina⁹  Agnes Fernández-Clotet^1,10  Eva Romero^1,11  Nuria Jiménez^1,12  José María Huguet^1,13  Ana Gutiérrez^1,14  Pedro Delgado-Guillena^1,15  Carlos Tardillo^1,16  Blanca Del Val^1,17  José Manuel Benítez^1,18  Elena Peña^1,19  Jesús Castro-Poceiro^2,20  Yamile Zabana^2,21  Albert Martin-Cardona^2,21  Luigi Melcarne^2,22  Iria Bastón-Rey^2,23  Manuel Barreiro-De Acosta^2,23  Cristina Calvino-Suárez^2,23  Laura Nieto-García^2,23  Luis Menchén^2,24  Ignacio Marín^2,24  José Miranda-Bautista^2,24  Rocío Plaza^2,25  José Luis Rueda^2,26  Cristina Suárez Ferrer^2,26  Montserrat Rivero^2,27  María José García^2,27  Beatriz Castro^2,27  Diego Casas-Deza^2,28  Luis Javier Lamuela^2,28  Olivia Sierra^2,28  Ismael El Hajra^2,29  Irene González-Partida^2,29  Antonio López-San Román^3,30  Eugenia Sánchez^3,30  Rubén Sánchez-Aldehuelo^3,30  Francisco Mesonero^3,30  Esteban Fuentes-Valenzuela^3,31  Rodrigo Nájera-Muñoz^3,31  Eduardo Leo-Carnerero^3,32  Andrea Nuñez^3,32  María Dolores De la Cruz^3,32  José Manuel Herrera^3,32  Patricia Ramírez De la Piscina^3,33  Saioa De la Maza^3,34  Nerea Hernández-Aretxabaleta^3,34  Marta Izquierdo^3,35  Carmen Dueñas^3,36  María Carmen Rodríguez-Grau^3,37  María Chaparro^3,38  Micaela Riat Castro^3,38  Javier P. Gisbert^3,38  Cristina Rubín de Célix^3,38  Abdel Bouhmidi^3,39  María González-Vivó^4,40  Jesús Martínez-Cadilla^4,41 

[1] ;Colorectal Unit, Department of General and Digestive Surgery, Hospital Universitario Marqués de Valdecilla, 39008 Santander, Spain;Department of Colorectal and Gastrointestinal Surgery, Hospital General Universitario de Elche, 03203 Alicante, Spain;Department of Colorectal and Gastrointestinal Surgery, Hospital Universitario Gregorio Marañón, 28009 Madrid, Spain;Department of Gastroenterology, Hospital Universitario Central de Asturias, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Spain;Gastroenterology Department, Complejo Hospitalario Universitario de Pontevedra, 36071 Pontevedra, Spain;Gastroenterology Department, Complejo Hospitalario de Soria, 42005 Soria, Spain;Gastroenterology Department, Consorcio Sanitario de Terrasa, 08227 Barcelona, Spain;Gastroenterology Department, Hospital Arquitecto Marcide, 15405 Ferrol, Spain;Gastroenterology Department, Hospital Clinic of Barcelona, 08036 Barcelona, Spain;Gastroenterology Department, Hospital Clínico Universitario de Valencia, 46010 Valencia, Spain;Gastroenterology Department, Hospital General Universitario de Elche, 03203 Alicante, Spain;Gastroenterology Department, Hospital General Universitario de Valencia, 46014 Valencia, Spain;Gastroenterology Department, Hospital General de Alicante, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), 03010 Alicante, Spain;Gastroenterology Department, Hospital General de Granollers, 08042 Granollers, Spain;Gastroenterology Department, Hospital Nuestra Señora de la Candelaria, 38010 Tenerife, Spain;Gastroenterology Department, Hospital Rafael Méndez, 30817 Lorca, Spain;Gastroenterology Department, Hospital Reina Sofía, IMIBIC, 14004 Córdoba, Spain;Gastroenterology Department, Hospital Royo Villanova, 50007 Zaragoza, Spain;Gastroenterology Department, Hospital Sant Joan Despí-Moisès Broggi, 08970 Barcelona, Spain;Gastroenterology Department, Hospital Universitari Mútua Terrassa, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), 08221 Terrassa, Spain;Gastroenterology Department, Hospital Universitari Parc Taulí, Sabadell, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), 08208 Barcelona, Spain;Gastroenterology Department, Hospital Universitario Clínico de Santiago, 15706 Santiago de Compostela, Spain;Gastroenterology Department, Hospital Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), and Departamento de Medicina, Universidad Complutense, 28009 Madrid, Spain;Gastroenterology Department, Hospital Universitario Infanta Leonor, Vallecas, 28031 Madrid, Spain;Gastroenterology Department, Hospital Universitario La Paz, 28046 Madrid, Spain;Gastroenterology Department, Hospital Universitario Marqués de Valdecilla, Universidad de Cantabria, Instituto de Investigación Sanitaria Valdecilla (IDIVAL), 37008 Santander, Spain;Gastroenterology Department, Hospital Universitario Miguel Servet, Instituto de Investigación Sanitaria Aragón (IISA), 50009 Zaragoza, Spain;Gastroenterology Department, Hospital Universitario Puerta de Hierro, 28220 Majadahonda, Spain;Gastroenterology Department, Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain;Gastroenterology Department, Hospital Universitario Río Hortega, 47012 Valladolid, Spain;Gastroenterology Department, Hospital Universitario Virgen del Rocío, 41013 Sevilla, Spain;Gastroenterology Department, Hospital Universitario Vitoria-Gastéiz, 01002 Vitoria, Spain;Gastroenterology Department, Hospital Universitario de Basurto, 48013 Bilbao, Spain;Gastroenterology Department, Hospital Universitario de Cabueñes, 33203 Gijón, Spain;Gastroenterology Department, Hospital Universitario de Cáceres, 10003 Cáceres, Spain;Gastroenterology Department, Hospital Universitario de Henares, 28002 Coslada, Spain;Gastroenterology Department, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP), Universidad Autónoma de Madrid (UAM), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), 28006 Madrid, Spain;Gastroenterology Department, Hospital de Santa Bárbara, 13500 Puertollano, Spain;Gastroenterology Department, Hospital del Mar, 08003 Barcelona, Spain;Gastroenterology Department, Hospital Álvaro Cunqueiro de Vigo, 36312 Vigo, Spain;

关键词: inflammatory bowel disease;    Crohn’s disease;    ulcerative colitis;    anti-TNF;    ustekinumab;    vedolizumab;   

DOI  :  10.3390/jcm10194402

来源: DOAJ

【 摘 要 】

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.

【 授权许可】

Unknown