The risk of post-operative complications associated with infliximab therapy for Crohn's disease: a controlled cohort study.
BACKGROUND
By temporarily suppressing the immune response, the anti-tumour necrosis factor agent, infliximab, may increase the risk of peri-operative complications.


OBJECTIVE
To test this hypothesis for intestinal resection in a cohort of 313 Crohn's disease patients treated with infliximab. Forty received one or more infusions prior to intestinal resection (31/40 within 12 weeks).


METHODS
The post-operative events of these patients were compared with those of a control group (infliximab naive) of 39 patients adjusted for age, gender and surgical procedure. Early (10 days) and late (3 months) major or minor complications were identified.


RESULTS
The incidence of early minor (15.0% vs. 12.8%) and major (12.5% vs. 7.7%) and late minor (2.5% vs. 5.1%) and major (17.5% vs. 12.8%) complications and the mean hospital stay after surgery (10.3 +/- 4.0 days vs. 9.9 +/- 5.5 days) were similar in both groups. A trend towards an increased early infection rate was found in infliximab pre-treated patients (6 vs. 1; P = 0.10), but more patients in this group received corticosteroids and/or immunosuppressives (29 vs. 16 patients; P < 0.05).


CONCLUSIONS
The use of infliximab before intestinal resection does not prolong the hospital stay and does not increase the rate of post-operative complications.
Marchal
L
L
Department of Gastroenterology, University Hospital Gasthuisberg, Leuven, Belgium.
D'Haens
G
G
Van Assche
G
G
Vermeire
S
S
Noman
M
M
Ferrante
M
M
Hiele
M
M
Bueno De Mesquita
M
M
D'Hoore
A
A
Penninckx
F
F
Rutgeerts
P
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D000911:Antibodies, Monoclonal / Q000009:adverse effects*; D015331:Cohort Studies; D003424:Crohn Disease / Q000601:surgery*; D005260:Female; D005765:Gastrointestinal Agents / Q000009:adverse effects*; D006801:Humans; D000069285:Infliximab; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000139:chemically induced*; D012189:Retrospective Studies; D012307:Risk Factors
D000911:Antibodies, Monoclonal; D005765:Gastrointestinal Agents; D000069285:Infliximab