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 journalArticle

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

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Inflammatory Bowel Diseases
Crohn Disease
Recurrence
Mesalamine
Colonic Diseases
Incidence
Azathioprine
Endoscopy
Therapeutics
Prospective Studies

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 journalArticle

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'Incà, R, Martinato, M, Castiglione, F, Papi, C, Annese, V, Gionchetti, P, Rizzello, F, Vernia, P, Biancone, L, Kohn, A & Cottone, M 2014, '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', Journal of Crohn's & colitis, vol. 8, no. 10, pp. 1217-1221. https://doi.org/10.1016/j.crohns.2014.02.010
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. / 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. In: Journal of Crohn's & colitis. 2014 ; Vol. 8, No. 10. pp. 1217-1221.
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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.",
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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.

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KW - 5-Aminosalicylic acid

KW - Crohn's disease

KW - Endoscopic recurrence

KW - Severe recurrence

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