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

Ambrogio Orlando, Filippo Mocciaro, Sara Renna, Daniela Scimeca, Antonio Rispo, Maria Lia Scribano, Anna Testa, Annalisa Aratari, Fabrizio Bossa, Rosy Tambasco, Erika Angelucci, Sara Onali, Maria Cappello, Walter Fries, Renata D'Incà, Matteo Martinato, Fabiana Castiglione, Claudio Papi, Vito Annese, Paolo GionchettiFernando Rizzello, Piero Vernia, Livia Biancone, Anna Kohn, Mario Cottone

Research output: Contribution to journalArticlepeer-review

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 languageEnglish
Pages (from-to)1217-1221
Number of pages5
JournalJournal of Crohn's & colitis
Volume8
Issue number10
DOIs
Publication statusPublished - Oct 1 2014

Keywords

  • 5-Aminosalicylic acid
  • Crohn's disease
  • Endoscopic recurrence
  • Severe recurrence

ASJC Scopus subject areas

  • Gastroenterology
  • Medicine(all)

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