Ustekinumab is more effective than azathioprine to prevent endoscopic postoperative recurrence in Crohn's disease

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TitreUstekinumab is more effective than azathioprine to prevent endoscopic postoperative recurrence in Crohn's disease
Type de publicationJournal Article
Year of Publication2021
AuteursBuisson A, Nancey S, Manlay L, Rubin DT, Hebuterne X, Pariente B, Fumery M, Laharie D, Roblin X, Bommelaer G, Pereira B, Peyrin-Biroulet L, Vuitton L, Grp USTEKPost-Op St
JournalUNITED EUROPEAN GASTROENTEROLOGY JOURNAL
Volume9
Pagination552-560
Date PublishedJUN
Type of ArticleArticle
ISSN2050-6406
Mots-clésazathioprine, Crohn&apos, postoperative recurrence, s disease, Ustekinumab
Résumé

{Background Preventing postoperative recurrence (POR) is a major concern in Crohn's disease (CD). While azathioprine is an option, no data is available on ustekinumab efficacy in this situation. Aims We compared the effectiveness of ustekinumab versus azathioprine in preventing endoscopic POR in CD. Methods We retrospectively collected data from all consecutive CD patients treated with ustekinumab after intestinal resection in 9 centers. The control group (azathioprine alone) was composed of patients who participated in a randomized controlled trial conducted in the same centers comparing azathioprine alone or in combination with curcumin. Propensity score analyses (inversed probability of treatment weighting = IPTW) were applied to compare the two groups. The primary endpoint was endoscopic POR (Rutgeerts' index >= i2) at 6 months. Results Overall, 32 patients were included in the ustekinumab group and 31 in the azathioprine group. The propensity score analysis was adjusted on the main risk factors (smoking, fistulizing phenotype, prior bowel resection, resection length >30 cm and >= 2 biologics before surgery) and thiopurines or ustekinumab exposure prior to surgery making the two arms comparable ( divide d divide < 0.2). After IPTW, the rate of endoscopic POR at 6 months was lower in patients treated with ustekinumab compared to azathioprine (28.0% vs. 54.5%

DOI10.1002/ueg2.12068