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The prevention and management of Crohn's disease postoperative recurrence: results from the Y-ECCO/ClinCom 2019 Survey

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Clinical Research Committee (ClinCom) of ECCO and Young ECCO Committee (Y-ECCO). / The prevention and management of Crohn's disease postoperative recurrence : results from the Y-ECCO/ClinCom 2019 Survey. I: European journal of gastroenterology & hepatology. 2020 ; Bind 32, Nr. 8. s. 1062-1066.

Bibtex

@article{6768369347ad40db903a5832e6b7adad,
title = "The prevention and management of Crohn's disease postoperative recurrence: results from the Y-ECCO/ClinCom 2019 Survey",
abstract = "BACKGROUND: Prevention and management of postoperative recurrence (POR) is a controversial field in Crohn's disease. The aim of this survey was to report common practice in real-life settings.METHODS: An 11-question survey was distributed among gastroenterologists attending the 14th European Crohn's and Colitis Organisation (ECCO) congress.RESULTS: Postoperative endoscopy to assess recurrence was routinely performed within 12 months by 87{\%} of respondents. Forty-six percent of clinicians reported to maintain endoscopic assessment in routine follow-up even after first negative colonoscopy. Most respondents (60{\%}) considered starting postoperative immunoprophylaxis in na{\"i}ve patients if one or more known risk factors were present. The number of risk factors was an important driver for prescribing biologics over immunosuppressants for 60{\%} of respondents.In case of fistulizing phenotype, perianal disease, or concomitant colonic involvement, the majority of physicians reported to start an immediate prophylaxis in 85, 98 and 88{\%} of patients, respectively. A significant percentage of clinicians were more prone to an endoscopy-driven treatment in long-standing disease after failure of thiopurines (51{\%}) and elderly (43{\%}).CONCLUSION: Endoscopy within the first year after surgery to assess POR has become routine in most centres. The high rate of early prophylaxis with expensive biologics despite missing solid evidence highlights the need for more randomized trials.",
keywords = "biologics, Crohn's disease, immunoprophylaxis, postoperative recurrence, prevention",
author = "Gabriele Dragoni and Nik Ding and Gecse, {Krisztina B} and Mansfield, {John C} and Uri Kopylov and Laurent Beaugerie and Peter Bossuyt and Shaji Sebastian and Monica Milla and Siro Bagnoli and Yassin, {Nuha A} and Dominik Bettenworth and Johan Burisch and Charlotte Hedin and Gisbert, {Javier P} and Marc Ferrante and {Clinical Research Committee (ClinCom) of ECCO and Young ECCO Committee (Y-ECCO)}",
year = "2020",
month = "8",
doi = "10.1097/MEG.0000000000001729",
language = "English",
volume = "32",
pages = "1062--1066",
journal = "European Journal of Gastroenterology and Hepatology",
issn = "0954-691X",
publisher = "Lippincott Williams & Wilkins",
number = "8",

}

RIS

TY - JOUR

T1 - The prevention and management of Crohn's disease postoperative recurrence

T2 - results from the Y-ECCO/ClinCom 2019 Survey

AU - Dragoni, Gabriele

AU - Ding, Nik

AU - Gecse, Krisztina B

AU - Mansfield, John C

AU - Kopylov, Uri

AU - Beaugerie, Laurent

AU - Bossuyt, Peter

AU - Sebastian, Shaji

AU - Milla, Monica

AU - Bagnoli, Siro

AU - Yassin, Nuha A

AU - Bettenworth, Dominik

AU - Burisch, Johan

AU - Hedin, Charlotte

AU - Gisbert, Javier P

AU - Ferrante, Marc

AU - Clinical Research Committee (ClinCom) of ECCO and Young ECCO Committee (Y-ECCO)

PY - 2020/8

Y1 - 2020/8

N2 - BACKGROUND: Prevention and management of postoperative recurrence (POR) is a controversial field in Crohn's disease. The aim of this survey was to report common practice in real-life settings.METHODS: An 11-question survey was distributed among gastroenterologists attending the 14th European Crohn's and Colitis Organisation (ECCO) congress.RESULTS: Postoperative endoscopy to assess recurrence was routinely performed within 12 months by 87% of respondents. Forty-six percent of clinicians reported to maintain endoscopic assessment in routine follow-up even after first negative colonoscopy. Most respondents (60%) considered starting postoperative immunoprophylaxis in naïve patients if one or more known risk factors were present. The number of risk factors was an important driver for prescribing biologics over immunosuppressants for 60% of respondents.In case of fistulizing phenotype, perianal disease, or concomitant colonic involvement, the majority of physicians reported to start an immediate prophylaxis in 85, 98 and 88% of patients, respectively. A significant percentage of clinicians were more prone to an endoscopy-driven treatment in long-standing disease after failure of thiopurines (51%) and elderly (43%).CONCLUSION: Endoscopy within the first year after surgery to assess POR has become routine in most centres. The high rate of early prophylaxis with expensive biologics despite missing solid evidence highlights the need for more randomized trials.

AB - BACKGROUND: Prevention and management of postoperative recurrence (POR) is a controversial field in Crohn's disease. The aim of this survey was to report common practice in real-life settings.METHODS: An 11-question survey was distributed among gastroenterologists attending the 14th European Crohn's and Colitis Organisation (ECCO) congress.RESULTS: Postoperative endoscopy to assess recurrence was routinely performed within 12 months by 87% of respondents. Forty-six percent of clinicians reported to maintain endoscopic assessment in routine follow-up even after first negative colonoscopy. Most respondents (60%) considered starting postoperative immunoprophylaxis in naïve patients if one or more known risk factors were present. The number of risk factors was an important driver for prescribing biologics over immunosuppressants for 60% of respondents.In case of fistulizing phenotype, perianal disease, or concomitant colonic involvement, the majority of physicians reported to start an immediate prophylaxis in 85, 98 and 88% of patients, respectively. A significant percentage of clinicians were more prone to an endoscopy-driven treatment in long-standing disease after failure of thiopurines (51%) and elderly (43%).CONCLUSION: Endoscopy within the first year after surgery to assess POR has become routine in most centres. The high rate of early prophylaxis with expensive biologics despite missing solid evidence highlights the need for more randomized trials.

KW - biologics

KW - Crohn's disease

KW - immunoprophylaxis

KW - postoperative recurrence

KW - prevention

UR - http://www.scopus.com/inward/record.url?scp=85088503060&partnerID=8YFLogxK

U2 - 10.1097/MEG.0000000000001729

DO - 10.1097/MEG.0000000000001729

M3 - Journal article

VL - 32

SP - 1062

EP - 1066

JO - European Journal of Gastroenterology and Hepatology

JF - European Journal of Gastroenterology and Hepatology

SN - 0954-691X

IS - 8

ER -

ID: 59661551