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The impact of postoperative infliximab maintenance therapy on preventing the surgical recurrence of Crohn’s disease: a single-center paired case–control study

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Abstract

Purpose

Preventing a recurrence of Crohn’s disease is a problem that remains to be solved. We evaluated the impact of using infliximab as a postoperative therapy on preventing the surgical recurrence of Crohn’s disease.

Methods

We performed a pair-matched study comparing 100 patients who had received postoperative infliximab maintenance therapy with those who had not between 1995 and 2010. The patients were matched by gender, Vienna classification and age at the time of the operation. Crohn’s disease-related reoperation was evaluated as surgical recurrence.

Results

In the postoperative infliximab maintenance therapy group, infliximab was administrated within 8 weeks after the operation. The median follow-up period was 36 months in the postoperative infliximab maintenance therapy group and 51 months in the control group. Surgical recurrences were recognized in 37 patients (three in the postoperative infliximab maintenance therapy group and 34 in the control group). A univariate analysis by the Kaplan–Meier method identified a body mass index >18 at the time of the operation (HR 0.19, p = 0.01) and postoperative infliximab maintenance therapy (HR 0.22, p = 0.0022) as factors related to the reduction of surgical recurrence. The multivariate analysis revealed that postoperative infliximab maintenance therapy was the only significant factor preventing surgical recurrence.

Conclusion

Postoperative infliximab maintenance therapy for Crohn’s disease prevents surgical recurrence, at least within 3 years after the operation.

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Acknowledgments

The authors thank Tomomi Yamada Ph.D. (Translational Medical Science, Mie University School of Medicine) for her critical comments and suggestions on the statistical analysis.

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Authors and Affiliations

  1. Division of Reparative Medicine, Department of Gastrointestinal and Pediatric Surgery, Institute of Life Sciences Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan

    Toshimitsu Araki, Keiichi Uchida, Yoshiki Okita, Hiroyuki Fujikawa, Mikihiro Inoue, Masaki Ohi, Koji Tanaka, Yasuhiro Inoue, Yasuhiko Mohri & Masato Kusunoki

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  1. Toshimitsu Araki
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  2. Keiichi Uchida
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  3. Yoshiki Okita
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Correspondence to Toshimitsu Araki.

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Araki, T., Uchida, K., Okita, Y. et al. The impact of postoperative infliximab maintenance therapy on preventing the surgical recurrence of Crohn’s disease: a single-center paired case–control study. Surg Today 44, 291–296 (2014). https://doi.org/10.1007/s00595-013-0538-0

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  • DOI: https://doi.org/10.1007/s00595-013-0538-0

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