Introduction: The incidence of endoscopic recurrence (ER) in Crohn's disease following curative resection is up to 75% at 1. year. Endoscopy is the most sensitive method to detect the earliest mucosal changes and the severe ER at 1. year seems to predict a clinical relapse. Methods: The aim of this prospective study was to evaluate the incidence of early ER 6. months after curative resection. Secondary outcome was to evaluate the role of 5-aminosalicylic acid (5-ASA) in the prevention of ER at 6. months. A total of 170 patients were included in the study. They were carried-out from the evaluation of the appearance of ER during a trial performed to assess the role of azathioprine vs. 5-ASA as early treatment of severe ER. All the patients started 5-ASA treatment 2. weeks after surgery. Results: Six months after surgery ER was observed in 105 patients (62%). The endoscopic score was reported as severe in 78.1% of them (82 out of 105). At univariable analysis only ileo-colonic disease influenced the final outcome associating to a lower risk of severe ER (p. =. 0.04; OR 0.52, 95% CI 0.277-0.974). Conclusion: In this prospective Italian multicenter IG-IBD study a great proportion of ER occur within 6. months from ileo-colonic resection, with a significant rate of severe ER. Furthermore this study confirms the marginal role of 5-ASA in the prevention of ER. This suggests that post-surgical endoscopic evaluation should be performed at 6. months instead of 1. year to allow an adequate early treatment.
Early post-operative endoscopic recurrence in Crohn's disease patients: Data from an Italian Group for the study of inflammatory bowel disease (IG-IBD) study on a large prospective multicenter cohort / Orlando, A.; Mocciaro, F.; Renna, S.; Scimeca, D.; Rispo, A.; Lia Scribano, M.; Testa, A.; Aratari, A.; Bossa, F.; Tambasco, R.; Angelucci, E.; Onali, S.; Cappello, M.; Fries, W.; D'Inca, R.; Martinato, M.; Castiglione, F.; Papi, C.; Annese, V.; Gionchetti, P.; Rizzello, F.; Vernia, P.; Biancone, L.; Kohn, A.; Cottone, M.. - In: JOURNAL OF CROHN'S AND COLITIS. - ISSN 1873-9946. - 8:10(2014), pp. 1217-1221. [10.1016/j.crohns.2014.02.010]
Early post-operative endoscopic recurrence in Crohn's disease patients: Data from an Italian Group for the study of inflammatory bowel disease (IG-IBD) study on a large prospective multicenter cohort
Annese V.;
2014-01-01
Abstract
Introduction: The incidence of endoscopic recurrence (ER) in Crohn's disease following curative resection is up to 75% at 1. year. Endoscopy is the most sensitive method to detect the earliest mucosal changes and the severe ER at 1. year seems to predict a clinical relapse. Methods: The aim of this prospective study was to evaluate the incidence of early ER 6. months after curative resection. Secondary outcome was to evaluate the role of 5-aminosalicylic acid (5-ASA) in the prevention of ER at 6. months. A total of 170 patients were included in the study. They were carried-out from the evaluation of the appearance of ER during a trial performed to assess the role of azathioprine vs. 5-ASA as early treatment of severe ER. All the patients started 5-ASA treatment 2. weeks after surgery. Results: Six months after surgery ER was observed in 105 patients (62%). The endoscopic score was reported as severe in 78.1% of them (82 out of 105). At univariable analysis only ileo-colonic disease influenced the final outcome associating to a lower risk of severe ER (p. =. 0.04; OR 0.52, 95% CI 0.277-0.974). Conclusion: In this prospective Italian multicenter IG-IBD study a great proportion of ER occur within 6. months from ileo-colonic resection, with a significant rate of severe ER. Furthermore this study confirms the marginal role of 5-ASA in the prevention of ER. This suggests that post-surgical endoscopic evaluation should be performed at 6. months instead of 1. year to allow an adequate early treatment.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
