title: State-of-the-art medical prevention of postoperative recurrence of Crohn's disease.
abstract: Postoperative recurrence of Crohn's disease is a frequent and often severe sequela of the disease. Until a few years ago it was deemed inescapable, as all the conventional medications used to treat the disease have been proven of little benefit in preventing recurrence after surgical treatment. In the past few years, anti-TNF agents given immediately after surgery have shown a remarkable efficacy in the prevention of disease recurrence. Large, randomized, controlled trials are currently underway to confirm these findings. Anti-TNF treatment of endoscopic lesions that occur after surgery seems to be less effective than using TNF antagonists to prevent recurrence. However, although the data are limited, this treatment strategy seems to be still superior to all the other prevention strategies that are not based on anti-TNF agents. Limited data are available on long-term outcomes of patients treated with anti-TNF agents after surgery. They suggest that these medications are safe and effective after many years of treatment. In addition, these agents might prevent recurrence even at doses lower than those used in patients with Crohn's disease who have not had surgery.
authors: Division of Gastroenterology, Virginia Tech-Carilion School of Medicine, 3 Riverside Circle, Roanoke, VA 24016, USA. sorrentino@uniud.it
authors: Dario
authors: D
authors: Sorrentino
mesh_terms: D000068879:Adalimumab; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D003424:Crohn Disease / Q000517:prevention & control* / Q000601:surgery*; D019468:Disease Management; D006801:Humans; D000069285:Infliximab; D011184:Postoperative Period; D012307:Risk Factors; D055502:Secondary Prevention; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab; D000068879:Adalimumab
references: Dig Liver Dis. 2012 Jun;44(6):453-60
references: 22265329
references: Clin Gastroenterol Hepatol. 2010 Jul;8(7):556-8
references: 20417722
references: Scand J Gastroenterol. 2005 Dec;40(12):1431-7
references: 16316891
references: Gut. 2001 Jul;49(1):42-6
references: 11413109
references: Clin Gastroenterol Hepatol. 2010 Jul;8(7):591-9.e1; quiz e78-9
references: 20139033
references: Gastroenterology. 2008 Oct;135(4):1123-9
references: 18727929
references: Eur J Gastroenterol Hepatol. 1999 Mar;11(3):277-82
references: 10333200
references: Dis Colon Rectum. 1996 Mar;39(3):335-41
references: 8603558
references: Cochrane Database Syst Rev. 2009 Oct 07;(4):CD006873
references: 19821389
references: Gut. 2010 Jun;59(6):752-9
references: 20551460
references: Gastroenterology. 2007 Mar;132(3):863-73; quiz 1165-6
references: 17324398
references: N Engl J Med. 2009 Aug 27;361(9):888-98
references: 19710487
references: Can J Gastroenterol. 2011 Mar;25(3):140-6
references: 21499578
references: Gastroenterology. 1995 Feb;108(2):345-9
references: 7835575
references: Gastroenterology. 2008 Nov;135(5):1500-9
references: 18823987
references: N Engl J Med. 2010 Apr 15;362(15):1383-95
references: 20393175
references: Gastroenterology. 1997 Apr;112(4):1069-77
references: 9097988
references: Int J Colorectal Dis. 2012 Jul;27(7):947-52
references: 22231620
references: Gastroenterology. 1994 Mar;106(3):643-8
references: 8119535
references: Gastroenterology. 2004 Sep;127(3):723-9
references: 15362027
references: Gastroenterology. 2004 Sep;127(3):730-40
references: 15362028
references: Inflamm Bowel Dis. 2009 Aug;15(8):1264-75
references: 19235918
references: Gastroenterology. 2007 Jan;132(1):52-65
references: 17241859
references: Inflamm Bowel Dis. 2012 Jan;18(1):17-24
references: 21381153
references: Int J Colorectal Dis. 2007 Sep;22(9):1061-9
references: 17534633
references: Inflamm Bowel Dis. 2010 Feb;16(2):198-203
references: 19504611
references: Inflamm Bowel Dis. 2009 Oct;15(10):1499-507
references: 19338051
references: Gastroenterology. 1997 Dec;113(6):1823-7
references: 9394721
references: Gastroenterology. 2005 Apr;128(4):856-61
references: 15825069
references: Gut. 2006 Oct;55(10):1525-6
references: 16966711
references: Radiology. 2010 Mar;254(3):755-64
references: 20177090
references: Inflamm Bowel Dis. 2011 Jul;17(7):1547-56
references: 21674711
references: Dis Colon Rectum. 2007 Nov;50(11):1968-86
references: 17762967
references: Aliment Pharmacol Ther. 2011 Jul;34(1):1-10
references: 21539588
references: Inflamm Bowel Dis. 2012 Apr;18(4):758-77
references: 21830279
references: Aliment Pharmacol Ther. 2003 Feb 15;17(4):517-23
references: 12622760
references: Gastroenterology. 2002 Feb;122(2):512-30
references: 11832465
references: World J Gastroenterol. 2010 Nov 21;16(43):5405-10
references: 21086556
references: Inflamm Bowel Dis. 2008 Sep;14(9):1240-5
references: 18398896
references: Gastrointest Endosc. 2006 Mar;63(3):486-92
references: 16500402
references: Inflamm Bowel Dis. 2009 Jul;15(7):1071-5
references: 19229992
references: Gut. 2007 Sep;56(9):1181-3
references: 17698862
references: Br J Surg. 2000 Dec;87(12):1697-701
references: 11122187
references: N Engl J Med. 2003 Feb 13;348(7):601-8
references: 12584368
references: J Crohns Colitis. 2010 Feb;4(1):63-101
references: 21122490
references: Ann Surg. 1996 Mar;223(3):253-60
references: 8604905
references: Gut. 2009 Apr;58(4):492-500
references: 18832518
references: Curr Gastroenterol Rep. 2011 Feb;13(1):95-100
references: 21042888
references: Int J Colorectal Dis. 2013 Mar;28(3):335-40
references: 23014978
references: Gastroenterology. 2000 Feb;118(2):264-73
references: 10648454
references: Gut. 2002 Sep;51(3):405-9
references: 12171964
references: Br J Surg. 2009 Jun;96(6):663-74
references: 19384912
references: Gastroenterology. 1995 Aug;109(2):404-13
references: 7615189
references: JAMA. 2006 May 17;295(19):2275-85
references: 16705109
references: Eur J Gastroenterol Hepatol. 2012 Apr;24(4):468-70
references: 22266834
references: Inflamm Bowel Dis. 2012 Sep;18(9):1617-23
references: 22081474
references: Inflamm Bowel Dis. 2009 Oct;15(10):1460-6
references: 19266566
references: J Crohns Colitis. 2012 Oct;6(9):924-31
references: 22424843
references: Gastroenterology. 2008 Oct;135(4):1420-2
references: 18773901
references: Dig Dis Sci. 2007 Feb;52(2):385-9
references: 17211699
references: Gastroenterology. 1999 Feb;116(2):294-300
references: 9922309
references: Digestion. 1989;42(4):224-32
references: 2572495
references: Am J Gastroenterol. 2009 Oct;104(10):2483-91
references: 19638967
references: World J Gastroenterol. 2011 Jul 21;17(27):3213-9
references: 21912470
references: Gastroenterology. 2009 Sep;137(3):1181-2; author reply 1182-3
references: 19632250
references: Dis Colon Rectum. 2005 May;48(5):963-9
references: 15785882
references: Scand J Gastroenterol. 2011 Mar;46(3):310-8
references: 21087119
references: Dis Colon Rectum. 2010 Feb;53(2):177-85
references: 20087093
references: Gastroenterology. 2010 Feb;138(2):463-8; quiz e10-1
references: 19818785
references: Inflamm Bowel Dis. 2012 Sep;18(9):1634-40
references: 22069022
references: Gastroenterology. 1997 Nov;113(5):1465-73
references: 9352848
references: Lancet. 1991 Sep 28;338(8770):771-4
references: 1681159
references: Aliment Pharmacol Ther. 2007 Jan 1;25(1):67-72
references: 17229221
references: Am J Gastroenterol. 2009 Aug;104(8):2089-96
references: 19568226
references: Surgery. 2001 Jan;129(1):96-102
references: 11150039
references: Lancet. 2002 May 4;359(9317):1541-9
references: 12047962
references: Inflamm Bowel Dis. 2011 Jan;17(1):118-26
references: 20848538
references: Dig Liver Dis. 2008 Jul;40 Suppl 2:S225-8
references: 18598993
references: Aliment Pharmacol Ther. 2010 Nov;32(9):1129-34
references: 20807218
references: Gastroenterology. 2009 Feb;136(2):441-50.e1; quiz 716
references: 19109962
references: Clin Gastroenterol Hepatol. 2008 Jun;6(6):616-20
references: 17967564
references: Am J Gastroenterol. 2009 Mar;104(3):760-7
references: 19174781
references: Inflamm Bowel Dis. 2007 Feb;13(2):135-42
references: 17206696
references: Gastroenterology. 2004 Sep;127(3):990-3
references: 15362055
references: Gut. 2006 Aug;55(8):1069-70
references: 16849342
references: Ann Surg. 1996 Oct;224(4):563-71; discussion 571-3
references: 8857860
references: Scand J Gastroenterol. 2012 May;47(5):518-27
references: 22375898
references: Gastroenterology. 2012 Jan;142(1):63-70.e5; quiz e31
references: 21945953
references: Eur J Gastroenterol Hepatol. 2006 Apr;18(4):457-9
references: 16538123
references: Inflamm Bowel Dis. 2013 Mar-Apr;19(4):E55-6
references: 22517503
references: Am J Gastroenterol. 2011 Apr;106(4):617-29
references: 21407190
references: Gastroenterology. 1998 Feb;114(2):262-7
references: 9453485
references: Acta Chir Scand Suppl. 1979;490:1-84
references: 293116
references: Int J Colorectal Dis. 1996;11(6):294-8
references: 9007626
references: Gut. 2005 Aug;54(8):1121-5
references: 16009685
references: Aliment Pharmacol Ther. 2012 Mar;35(6):625-33
references: 22313322
references: Gut. 2006 Jul;55(7):978-83
references: 16401689
references: Am J Gastroenterol. 2010 Jul;105(7):1574-82
references: 20234346
references: Lancet. 2008 Feb 23;371(9613):660-667
references: 18295023
references: Aliment Pharmacol Ther. 2011 Mar;33(6):707-13
references: 21251032
references: Immunity. 2009 Sep 18;31(3):401-11
references: 19766083
references: Gastroenterology. 1995 Jun;108(6):1617-21
references: 7768364
references: Gastroenterology. 2006 May;130(6):1595-606
references: 16697723
references: Br J Surg. 2000 Apr;87(4):398-404
references: 10759731
references: Gut. 2009 Sep;58(9):1218-25
references: 19625280
references: Gut. 2006 Jun;55(6):842-7
references: 16377775
references: Am J Gastroenterol. 2010 May;105(5):1158-64
references: 20010925
references: World J Gastroenterol. 2012 Aug 28;18(32):4391-8
references: 22969204
references: Int J Colorectal Dis. 2008 Dec;23(12):1213-21
references: 18762954
references: Gastroenterology. 1990 Oct;99(4):956-63
references: 2394349
references: Dig Dis Sci. 2012 May;57(5):1341-8
references: 22252267
references: Dig Liver Dis. 2011 Sep;43(9):698-702
references: 21474398
references: Arch Intern Med. 2007 Sep 10;167(16):1804-7
references: 17846401