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 postoperative 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; Scribano, Lm; Vernia, Piero. - In: JOURNAL OF CROHN'S AND COLITIS. - ISSN 1873-9946. - STAMPA. - 8:(2014), pp. 1217-1221. [10.1016/j.crohns.2014.02.010]

Early postoperative 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

VERNIA, Piero
2014

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.
2014
5-Aminosalicylic acid; Crohn's disease; endoscopic recurrence; severe recurrence
01 Pubblicazione su rivista::01a Articolo in rivista
Early postoperative 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; Scribano, Lm; Vernia, Piero. - In: JOURNAL OF CROHN'S AND COLITIS. - ISSN 1873-9946. - STAMPA. - 8:(2014), pp. 1217-1221. [10.1016/j.crohns.2014.02.010]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/559726
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