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

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.

GIONCHETTI, PAOLO;RIZZELLO, FERNANDO;
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
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 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. - In: JOURNAL OF CROHN'S AND COLITIS. - ISSN 1873-9946. - STAMPA. - 8:(2014), pp. 1217-1221. [10.1016/j.crohns.2014.02.010]
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
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11585/399813
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