Abstract
Crohn’s Disease (CD) and Ulcerative Colitis (UC), known as Inflammatory Bowel Diseases (IBD), are multifactorial, potentially debilitating diseases with probable genetic heterogeneity and unknown etiology. During the disease course of IBD, periods of inflammatory activity alternate with periods of remission. Severe complications in IBD often result in surgery. In the last two decades, major advances in medical treatment have changed the management of IBD. The advent of monoclonal antibodies targeting cytokines and adhesion molecules has brought a revolution in the treatment of IBD refractory to conventional therapy. However, it is not well established if these treatments could influence the long-term course of the diseases and the need for surgical treatment, though they have no severe adverse effects and improve quality of life. It has been shown that in the era of biologic agents, there has been a relative reduction in surgery rate for mild disease presentation, while the incidence of emergency or urgent surgery both for CD and UC remains unmodified. We summarized key data about current surgical rates in IBD after the advent of biologic agents.
Keywords: Inflammatory bowel diseases, Crohn's disease, ulcerative colitis, biologics, surgical treatment, biologic agents.
[1]
Ananthakrishnan AN, Weber LR, Knox JF, et al. Permanent work disability in Crohn’s disease. Am J Gastroenterol 2008; 103: 154-61.
[2]
Hanauer SB, Feagan BG, Lichtenstein GR, et al. Maintenance infliximab for Crohn’s disease: the ACCENT I randomised trial. Lancet 2002; 359(9317): 1541-9.
[3]
Sands BE, Anderson FH, Bernstein CN, et al. Infliximab maintenance therapy for fistulizing Crohn’s disease. N Engl J Med 2004; 350(9): 876-85.
[4]
Targan SR, Hanauer SB, van Deventer SJ, et al. A short-term study of chimeric monoclonal antibody cA2 to tumor necrosis factor alpha for Crohn’s disease. Crohn’s Disease cA2 Study Group. N Engl J Med 1997; 337(15): 1029-35.
[5]
Colombel JF, Sandborn WJ, Rutgeerts P, et al. Adalimumab for maintenance of clinical response and remission in patients with Crohn’s disease: the CHARM trial. Gastroenterology 2007; 132(1): 52-65.
[6]
Feagan BG, Panaccione R, Sandborn WJ, et al. Effects of adalimumab therapy on incidence of hospitalization and surgery in Crohn’s disease: results from the CHARM study. Gastroenterology 2008; 135(5): 1493-9.
[7]
Sandborn WJ, Rutgeerts P, Enns R, et al. Adalimumab induction therapy for Crohn disease previously treated with infliximab: a randomized trial. Ann Intern Med 2007; 146(12): 829-38.
[8]
Schreiber S, Khaliq-Kareemi M, Lawrance IC, et al. Maintenance therapy with certolizumab pegol for Crohn’s disease. N Engl J Med 2007; 357(3): 239-50.
[9]
Sandborn WJ, Colombel JF, Enns R, et al. Natalizumab induction and maintenance therapy for Crohn’s disease. N Engl J Med 2005; 353(18): 1912-25.
[10]
Duijvestein M, Battat R, Casteele NV, et al. (2018).novel therapies and treatment strategies for patients with inflammatory bowel disease. Curr Treat Options Gastroenterol 2018; 16(1): 129-46.
[11]
Lichtenstein GR, Yan S, Bala M, et al. Infliximab maintenance treatment reduces hospitalizations, surgeries, and procedures in fistulizing Crohn’s disease. Gastroenterology 2005; 128: 862-9.
[12]
Danese S, Fiorino G, Peyrin-Biroulet L. Early intervention in Crohn’s disease: towards disease modification trials. Gut 2017; 66(12): 2179-87.
[13]
Khanna R, Bressler B, Levesque BG, et al. REACT Study Investigators. Early combined immunosuppression for the management of Crohn’s disease (REACT): a cluster randomised controlled trial. Lancet 2015; 386(10006): 1825-34.
[14]
Fiorino G, Bonifacio C, Allocca M, et al. Bowel damage as assessed by the lémann index is reversible on anti-tnf therapy for crohn’s disease. J Crohn’s Colitis 2015; 9(8): 633-9.
[15]
Danese S, Fiorino G, Reinisch W. Review article: Causative factors and the clinical management of patients with Crohn’s disease who lose response to anti-TNF- alpha therapy. Aliment Pharmacol Ther 2011; 34(1): 1-10.
[16]
Berlin C, Berg EL, Briskin MJ, et al. Alpha 4 beta 7 integrin mediates lymphocyte binding to the mucosal vascular addressin MAdCAM-1. Cell 1993; 74(1): 185-95.
[17]
Feagan BG, Rutgeerts P, Sands BE, et al. Vedolizumab as induction and maintenance therapy for ulcerative colitis. N Engl J Med 2013; 369: 699-710.
[18]
Sandborn WJ, Feagan BG, Rutgeerts P, et al. Vedolizumab as induction and maintenance therapy for Crohn’s disease. N Engl J Med 2013; 369: 711-21.
[19]
Sands BE, Feagan BG, Rutgeerts P, et al. Effects of vedolizumab induction therapy for patients with Crohn’s disease in whom tumor necrosis factor antagonist treatment failed. Gastroenterology 2014; 147: 618-27.
[20]
Vermeire S, Loftus Jr EV, Colombel JF, et al. Long-term efficacy of vedolizumab for Crohn’s disease. J Crohn’s Colitis 2017; 11: 412-24.
[21]
Loftus Jr EV, Colombel JF, Feagan BG, et al. Long-term efficacy of vedolizumab for ulcerative colitis. J Crohn’s Colitis 2017; 11: 400-11.
[22]
Feagan BG, Sandborn WJ, Gasink C, et al. Ustekinumab as induction and maintenance therapy for Crohn’s disease. N Engl J Med 2016; 375(20): 1946-60.
[23]
Faiz O, Warusavitarne J, Bottle A, et al. Non elective excisional colorectal surgery in English National Health Service Trusts: A study of outcomes from hospital episode statistics data between 1996 and 2007. J Am Coll Surg 2010; 210: 390-401.
[24]
Annese V, Duricova D, Gower-Rousseau C, Jess T, Langholz E. Impact of new treatments on hospitalisation, surgery, infection, and mortality in IBD: a focus paper by the epidemiology committee of ECCO. J Crohn’s Colitis 2016; 10(2): 216-25.
[25]
Rungoe C, Langholz E, Andersson M, et al. Changes in medical treatment and surgery rates in inflammatory bowel disease: a nationwide cohort study 1979-2011. Gut 2014; 63(10): 1607-16.
[26]
Lakatos PL, Golovics PA, David G, et al. Has there been a change in the natural history of Crohn’s disease? Surgical rates and medical management in a population-based inception cohort from Western Hungary between 1977-2009. Am J Gastroenterol 2012; 107(4): 579-88.
[27]
Burisch J, Kiudelis G, Kupcinskas L, et al. Epi-IBD group. Natural disease course of Crohn's disease during the first 5 years after diagnosis in a European population-based inception cohort: an Epi-IBD study Gut 2018; pii: gutjnl-2017-315568.
[28]
Ananthakrishnan AN, McGinley EL, Binion DG, Saeian K. A nationwide analysis of changes in severity and outcomes of inflammatory bowel disease hospitalizations. J Gastrointest Surg 2011; 15(2): 267-76.
[29]
Hellers G. Crohn’s disease in Stockholm County from 1955-1974:
A study of epidemiology, results of surgical treatment, and longterm
prognosis. Acta Chir Scand Suppl 1979; 490 1e84
[30]
Hoie O, Wolters FL, Riis L, et al. Low colectomy rates in ulcerative colitis in an unselected European cohort followed for 10 years. Gastroenterology 2007; 132: 507-15.
[31]
Bernstein CN, Wajda A, Svenson LW, et al. The epidemiology of inflammatory bowel disease in Canada: A population-based study. Am J Gastroenterol 2006; 101: 1559-68.
[32]
Järnerot G, Hertervig E, Friis-Liby I, et al. Infliximab as rescue therapy in severe to moderately severe ulcerative colitis: a randomized, placebo-controlled study. Gastroenterology 2005; 128(7): 1805-11.
[33]
Teisner AS, Ainsworth MA, Brynskov J. Long-term effects and colectomy rates in ulcerative colitis patients treated with infliximab: a Danish single center experience. Scand J Gastroenterol 2010; 45(12): 1457-63.
[34]
Abou Khalil M, Boutros M, Nedjar H, et al. Incidence rates and predictors of colectomy for ulcerative colitis in the era of biologics: results from a provincial database. J Gastrointest Surg 2018; 22(1): 124-32.
[35]
Lynch RW, Lowe D, Protheroe A, et al. Outcomes of rescue therapy in acute severe ulcerative colitis: data from the United Kingdom inflammatory bowel disease audit. Aliment Pharmacol Ther 2013; 38: 935.e945.
[36]
Turner D, Walsh CM, Steinhart AH, Griffiths AM. Response to corticosteroids in severe ulcerative colitis: a systematic review of the literature and a meta-regression. Clin Gastroenterol Hepatol 2007; 5: 103.e110.
[37]
Powar MP, Martin P, Croft AR, et al. Surgical outcomes in steroid refractory acute severe ulcerative colitis: the impact of rescue therapy. Colorectal Dis 2013; 15: 374.e379.
[38]
Van Assche G, Vermeire S, Rutgeerts P. Management of acute severe ulcerative colitis. Gut 2011; 60: 130-3.
[39]
Thorne K, Alrubaiy L, Akbari A, et al. Colectomy rates in patients with ulcerative colitis following treatment with infliximab or ciclosporin: a systematic literature review. Eur J Gastroenterol Hepatol 2016; 28(4): 369-82.
[40]
Narula N, Marshall JK, Colombel JF, et al. Systematic review and meta-analysis: infliximab or cyclosporine as rescue therapy in patients with severe ulcerative colitis refractory to steroids. Am J Gastroenterol 2016; 111(4): 477-91.
[41]
Reinisch W, Sandborn WJ, Hommes DW, et al. Adalimumab for induction of clinical remission in moderately to severely active ulcerative colitis: results of a randomised controlled trial. Gut 2011; 60: 780-7.
[42]
Sandborn WJ, van Assche G, Reinisch W, et al. Adalimumab induces and maintains clinical remission in patients with moderate to-severe ulcerative colitis. Gastroenterology 2012; 142: 257-65.
[43]
Iborra M, Gisbert JP, Bosca-Watts MM, et al. Spanish Working Group on Crohn’s Disease and Ulcerative Colitis (GETECCU). Effectiveness of adalimumab for the treatment of ulcerative colitis in clinical practice: comparison between anti-tumour necrosis factor-naïve and non-naïve patients. J Gastroenterol 2017; 52(7): 875-7.
[44]
Taxonera C, Iglesias E, Muñoz F, et al. Adalimumab maintenance treatment in ulcerative colitis: outcomes by prior anti-tnf use and efficacy of dose escalation. Dig Dis Sci 2017; 62(2): 481-90.
[45]
Dotan I, Ron Y, Yanai H, et al. Patient factors that increase infliximab clearance and shorten half-life in inflammatory bowel disease: a population pharmacokinetic study. Inflamm Bowel Dis 2014; 20: 2247-59.
[46]
Sharma S, Eckert D, Hyams JS, et al. Pharmacokinetics and exposure-efficacy relationship of adalimumab in pediatric patients with moderate to severe Crohn’s disease: results from a randomized, multicenter, phase-3 study. Inflamm Bowel Dis 2015; 21: 783-92.
[47]
Kurnool S, Nguyen NH, Proudfoot J, Dulai PS, Boland BS. High body mass index is associated with increased risk of treatment failure and surgery in biologic-treated patients with ulcerative colitis. Aliment Pharmacol Ther 2018; 47(11): 1472-9.
[48]
Frolkis AD, Dykeman J, Negron ME, et al. Risk of surgery for inflammatory bowel diseases has decreased over time: a systematic review and metaanalysis of population-based studies. Gastroenterology 2013; 145: 996-1006.
[49]
Frolkis AD, Lipton DS, Fiest KM, et al. Cumulative incidence of second intestinal resection in Crohn’s disease: a systematic review and meta-analysis of population-based studies. Am J Gastroenterol 2014; 109: 1739-48.
[50]
Bernstein CN, Loftus EV Jr, Ng SC, Lakatos PL, Moum B. Epidemiology and natural history task force of the International Organization for the Study of Inflammatory Bowel Disease (IOIBD): Hospitalisations and surgery in Crohn’s disease. Gut 2012; 61(4): 622-9.
[51]
Ramadas AV, Gunesh S, Thomas GA, et al. Natural history of Crohn’s disease in a population-based cohort from Cardiff (1986-2003): A study of changes in medical treatment and surgical resection rates. Gut 2010; 59: 1200-6.
[52]
Cosnes J, Gower-Rousseau C, Seksik P, Cortot A. Epidemiology and natural history of inflammatory bowel diseases. Gastroenterology 2011; 140(6): 1785-94.
[53]
Binder V, Hendriksen C, Kreiner S. Prognosis in Crohn’s disease based on results from a regional patient group from the county of Copenhagen. Gut 1985; 26: 146.e50.
[54]
Munkholm P, Langholz E, Davidsen M, et al. Intestinal cancer risk and mortality in patients with Crohn’s disease. Gastroenterology 1993; 105: 1716.e23.
[55]
Vind I, Riis L, Jess T, et al. Increasing incidences of inflammatory bowel disease and decreasing surgery rates in Copenhagen City and County, 2003-2005; A population-based study from the Danish Crohn colitis database. Am J Gastroenterol 2006; 101: 1274.e82.
[56]
Odes S, Vardi H, Friger M, et al. European collaborative study on
inflammatory bowel disease. cost analysis and cost determinants in
a european inflammatory bowel disease inception cohort with 10
years of follow-up evaluation. Gastroenterology 2006; 131:719.e28.
[57]
Bernstein CN, Nabalamba A. Hospitalization, surgery and readmission rates of IBD in Canada: a population-based study. Am J Gastroenterol 2006; 101: 110.e18.
[58]
Slattery E, Keegan D, Hyland J, O’donoghue D, Mulcahy HE. Surgery, Crohn’s disease, and the biological era: has there been an impact? J Clin Gastroenterol 2011; 45(8): 691-3.
[59]
Rutgeerts P, Feagan BG, Lichtenstein GR, et al. Comparison of scheduled and episodic treatment strategies of infliximab in Crohn’s disease. Gastroenterology 2004; 126: 402-13.
[60]
Lichtenstein GR, Yan S, Bala M, Blank M, Sands BE. Infliximab maintenance treatment reduces hospitalizations, surgeries, and procedures in fistulizing Crohn’s disease. Gastroenterology 2005; 128: 862-9.
[61]
Costa J, Magro F, Caldeira D, et al. Infliximab reduces hospitalizations and surgery interventions in patients with inflammatory bowel disease: A systematic review and meta-analysis. Inflamm Bowel Dis 2013; 19: 2098-110.
[62]
Lakatos PL, Golovics PA, David G, et al. Has there been a change in the natural history of Crohn’s disease? Surgical rates and medical management in a population-based inception cohort from Western Hungary between 1977-2009. Am J Gastroenterol 2012; 107(4): 579-88.
[63]
Kotze PG, Magro DO, Saab B, et al. Comparison of time until elective intestinal resection regarding previous anti-tumor necrosis factor exposure: A Brazilian study on patients with Crohn’s disease. Intest Res 2018; 16(1): 62-8.
[64]
Cosnes J, Bourrier A, Laharie D, et al. Early administration of azathioprine vs conventional management of Crohn’s disease: A randomized controlled trial. Gastroenterology 2013; 145: 758-65.
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