Abstract
Most patients with Crohn's disease will require surgery during the course of their disease. However, surgery is not curative and post-operative recurrence is quite inexorable. One year after resection up to 80% of patients have new lesions at the neo-terminal ileum and after 10 years approximately 50% of patients will experience recurrence of symptoms and 35% will need further surgery. Prevention of post-operative recurrence has, therefore, a central role in the management of Crohn's Disease. Several drugs have been evaluated to decrease the risk of both endoscopic and clinical recurrence but the overall results are largely not impressive. Among the different drugs evaluated, mesalazine, antibiotics (metronidazole and ornidazole), thiopurines and anti-TNFα antibodies have been shown to be effective whereas budesonide, probiotics and interleukin 10 are not effective. This review focuses on the actual evidence on the prevention of postoperative recurrence: randomised controlled trials and meta-analyses are critically reviewed and discussed with particular attention to the methodological aspects.
Keywords: Crohn's disease, post-operative recurrence, mesalazine, thiopurines, biologic therapies, antibiotics, probiotics, budesonide
Reviews on Recent Clinical Trials
Title:Randomized Controlled Trials in Prevention of PostSurgical Recurrence in Crohn’s Disease
Volume: 7 Issue: 4
Author(s): Claudio Papi, Federica Fasci Spurio, Giovanna Margagnoni and Annalisa Aratari
Affiliation:
Keywords: Crohn's disease, post-operative recurrence, mesalazine, thiopurines, biologic therapies, antibiotics, probiotics, budesonide
Abstract: Most patients with Crohn's disease will require surgery during the course of their disease. However, surgery is not curative and post-operative recurrence is quite inexorable. One year after resection up to 80% of patients have new lesions at the neo-terminal ileum and after 10 years approximately 50% of patients will experience recurrence of symptoms and 35% will need further surgery. Prevention of post-operative recurrence has, therefore, a central role in the management of Crohn's Disease. Several drugs have been evaluated to decrease the risk of both endoscopic and clinical recurrence but the overall results are largely not impressive. Among the different drugs evaluated, mesalazine, antibiotics (metronidazole and ornidazole), thiopurines and anti-TNFα antibodies have been shown to be effective whereas budesonide, probiotics and interleukin 10 are not effective. This review focuses on the actual evidence on the prevention of postoperative recurrence: randomised controlled trials and meta-analyses are critically reviewed and discussed with particular attention to the methodological aspects.
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Cite this article as:
Papi Claudio, Fasci Spurio Federica, Margagnoni Giovanna and Aratari Annalisa, Randomized Controlled Trials in Prevention of PostSurgical Recurrence in Crohn’s Disease, Reviews on Recent Clinical Trials 2012; 7 (4) . https://dx.doi.org/10.2174/1574887111207040307
DOI https://dx.doi.org/10.2174/1574887111207040307 |
Print ISSN 1574-8871 |
Publisher Name Bentham Science Publisher |
Online ISSN 1876-1038 |
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