科研之友
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摘要
Background: Approximately 80% of patients with Crohn's disease will require surgery. Surgery for Crohn's disease is not curative, and recurrence is typical. In this cohort study, based on nationwide Danish registries, we examined the association between postoperative treatment with anti-tumor necrosis factor alpha (anti-TNF-alpha) agents and reoperation. Methods: The association was examined in cohort 1 = patients not treated with anti-TNF-alpha agents within 6 months before operation, cohort 2 = patients treated with anti-TNF-alpha agents within 6 months before operation. Within both cohorts, we defined postoperative exposure to anti-TNF-alpha agents as at least 1 treatment within 6 months after the first operation and the reference cohorts were those not treated. Patients were followed from 6 months after operation and until 5 years. We used Cox proportional-hazards regression to compute adjusted hazard ratios with 95% confidence intervals. Results: In cohort 1, 31 (1.3%) were treated with anti-TNF-alpha agents within 6 months after operation and compared with those not treated, the adjusted hazard ratio of reoperation among those treated with anti-TNF-alpha agents was 3.53 (95% confidence interval: 1.61-7.72). In cohort 2, 63 (16.3%) were treated with anti-TNF-alpha agents within 6 months after operation, and the corresponding adjusted hazard ratio of reoperation was 2.16 (95% confidence interval: 1.11-4.18). Conclusions: Our data suggest that anti-TNF-alpha treatment within 6 months after the first operation is not associated with a reduction in the need for subsequent operation. Uncontrolled confounding might have influenced our results, and, furthermore, future studies are warranted to clarify whether our study population is different from populations most often associated with postoperative anti-TNF-alpha treatment.
- 出版日期2016-3
