Post-Operative Crohn's Disease Recurrence: Impact of Endoscopic Monitoring and Treatment Step-up on Outcome

Reply to Yamamoto

“…We thank Dr Yamamoto for his interest in our recent article, ‘Post‐operative recurrence of Crohn's disease (CD): impact of endoscopic monitoring and treatment step‐up’ . One of its conclusions was that in our postoperative cohort there was no clinical benefit from colonoscopy or step‐up therapy.…”

Addition of mesalazine for subclinical post‐surgical endoscopic recurrence of Crohn's disease despite preventive thiopurine therapy: A case–control study

“…Most algorithms uphold biological therapy introduction for patients with ER despite thiopurine prevention . Nevertheless, there is lack of evidence of rescue therapy to treat post‐surgical recurrence, despite the use of preventive thiopurines started soon after surgery.…”

“…According to different algorithms, 4,[13][14][15] thiopurines are likely to be the most suitable treatment for preventing post-surgical recurrence in high-risk patients. Whether patients are on preventive medical therapy or not, it is also often advised to perform early endoscopic monitoring 4,14 to consider treatment escalation in case of early ER.…”

“…According to different algorithms, 4,[13][14][15] thiopurines are likely to be the most suitable treatment for preventing post-surgical recurrence in high-risk patients. Whether patients are on preventive medical therapy or not, it is also often advised to perform early endoscopic monitoring 4,14 to consider treatment escalation in case of early ER. Despite this approach, up to 50% of patients on thiopurines for post-surgical recurrence prevention may show ER within the first year following surgery, 16,17 and it has been shown that this percentage may increase over time.…”

Therapeutic strategies for prevention of postoperative recurrence in patients with Crohn's disease

“…We read, with interest, the article by De Cruz et al ., ‘Post‐operative recurrence of Crohn’s disease: impact of endoscopic monitoring and treatment step‐up’. Eighty‐nine per cent of patients receiving colonoscopy had a decision based on the endoscopic findings.…”