Preoperative Infliximab Therapy Does Not Increase Morbidity and Mortality After Laparoscopic Resection for Inflammatory Bowel Disease

Abstract

Infliximab is not associated with increased rates of postoperative complications after laparoscopic resection.

Anti‐TNF therapy is not associated with an increased risk of post‐colectomy complications, a population‐based study

“…Although severity scoring systems for UC exist [26], these data are not coded within HES. A few studies have managed to investigate the association of anti-TNF with postoperative complications and adjust for disease severity [5,[27][28][29][30]. Some of these studies reported an increased risk of postoperative complications with anti-TNF therapy [5,6,29] while the others reported no such association [27,28,30].…”

Systematic review of preoperative, intraoperative and postoperative risk factors for colorectal anastomotic leaks

“…A systematic review found an AL rate of 6·8 per cent in the corticosteroid group compared with 3·3 per cent in patients not treated with corticosteroid, but the duration and dose of treatment were heterogeneous. Infliximab alone may not alter AL risk, but in combination with other immune modulators can slow healing. There is evidence to suggest that mycophenolate mofetil, ciclosporin A, tacrolimus and everolimus all increase the risk of AL.…”

Systematic review with meta‐analysis: risk of post‐operative complications associated with pre‐operative exposure to anti‐tumour necrosis factor agents for Crohn’s disease

“…After full‐text review, we excluded 17 systematic reviews, three review articles, 14 non‐peer‐reviewed articles, three letters to the editor, two case series, nine articles with mixed data that could not be separated, one that included exposure to anti‐TNF agents after surgery, and one that enrolled patients with minor surgery. Finally, 20 eligible studies, including 19 cohort studies and one case‐control study, were subjected to qualitative review.…”

“…A total of 11 studies reporting OR after multivariate analysis of post‐operative total complications, including disease severity, co‐morbidities, concomitant medications, and others (details are summarised in Table S1), were pooled with a summary effect adjusted OR of 1.53 (95% CI, 1.11‐2.09; I 2 = 43.8%; P = 0.058), indicating a significantly higher rate of complications in patients treated with anti‐TNF agents than in controls (Figure ). Seven studies reporting post‐operative infectious complications were pooled, and the adjusted OR was 2.09 (95% CI, 1.19‐3.65; I 2 = 62.1%; P = 0.015), indicating a significantly higher rate of complications in patients treated with anti‐TNF agents than in controls (Figure ). Three studies reporting post‐operative non‐infectious complications were pooled, and the adjusted OR was 1.18 (95% CI, 0.69‐2.01; I 2 = 0.0%; P = 0.933), indicating a nonsignificant association (Figure ).…”