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.
| Original language | English |
|---|---|
| Pages (from-to) | 1217-1221 |
| Number of pages | 5 |
| Journal | Journal of Crohn's & colitis |
| Volume | 8 |
| Issue number | 10 |
| DOIs | |
| Publication status | Published - Oct 1 2014 |
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Keywords
- 5-Aminosalicylic acid
- Crohn's disease
- Endoscopic recurrence
- Severe recurrence
ASJC Scopus subject areas
- Gastroenterology
- Medicine(all)
Cite this
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, Ambrogio; Mocciaro, Filippo; Renna, Sara; Scimeca, Daniela; Rispo, Antonio; Lia Scribano, Maria; Testa, Anna; Aratari, Annalisa; Bossa, Fabrizio; Tambasco, Rosy; Angelucci, Erika; Onali, Sara; Cappello, Maria; Fries, Walter; D'Incà, Renata; Martinato, Matteo; Castiglione, Fabiana; Papi, Claudio; Annese, Vito; Gionchetti, Paolo; Rizzello, Fernando; Vernia, Piero; Biancone, Livia; Kohn, Anna; Cottone, Mario.
In: Journal of Crohn's & colitis, Vol. 8, No. 10, 01.10.2014, p. 1217-1221.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Early post-operative endoscopic recurrence in Crohn's disease patients
T2 - Data from an Italian Group for the study of inflammatory bowel disease (IG-IBD) study on a large prospective multicenter cohort
AU - Orlando, Ambrogio
AU - Mocciaro, Filippo
AU - Renna, Sara
AU - Scimeca, Daniela
AU - Rispo, Antonio
AU - Lia Scribano, Maria
AU - Testa, Anna
AU - Aratari, Annalisa
AU - Bossa, Fabrizio
AU - Tambasco, Rosy
AU - Angelucci, Erika
AU - Onali, Sara
AU - Cappello, Maria
AU - Fries, Walter
AU - D'Incà, Renata
AU - Martinato, Matteo
AU - Castiglione, Fabiana
AU - Papi, Claudio
AU - Annese, Vito
AU - Gionchetti, Paolo
AU - Rizzello, Fernando
AU - Vernia, Piero
AU - Biancone, Livia
AU - Kohn, Anna
AU - Cottone, Mario
PY - 2014/10/1
Y1 - 2014/10/1
N2 - 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.
AB - 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.
KW - 5-Aminosalicylic acid
KW - Crohn's disease
KW - Endoscopic recurrence
KW - Severe recurrence
UR - http://www.scopus.com/inward/record.url?scp=84908256578&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84908256578&partnerID=8YFLogxK
U2 - 10.1016/j.crohns.2014.02.010
DO - 10.1016/j.crohns.2014.02.010
M3 - Article
C2 - 24630485
AN - SCOPUS:84908256578
VL - 8
SP - 1217
EP - 1221
JO - Journal of Crohn's and Colitis
JF - Journal of Crohn's and Colitis
SN - 1873-9946
IS - 10
ER -