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Impact of Biologics and Small-Molecule Agents on Postoperative Complications in IBD: A Systematic Review.

Publication ,  Journal Article
Lee, KE; Sizemore, JA; Kim, G; Shen, B; Sands, BE
Published in: Diseases of the colon and rectum
June 2024

Patients with IBD may require colectomy for severe disease unresponsive or refractory to pharmacological therapy. The question of the impact of biologic use on postoperative complications is a topic of active investigation.A systematic literature review was performed to describe the current state of knowledge of the impact of perioperative biologic and tofacitinib use on postoperative complications in patients with IBD.PubMed and Cochrane databases were searched.Studies between January 2000 and January 2023, in any language, were searched, followed by a snowball search identifying further studies in accordance with Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. Articles regarding pediatric or endoscopic management were excluded.Preoperative or perioperative exposure to biologics in IBD was included.Infectious and noninfectious complications, including anastomotic leaks, surgical site infections, urinary tract infections, pneumonia, sepsis, septic shock, postoperative length of stay, readmission, and reoperation, were the main outcomes measured.A total of 28 studies were included for analysis in this review, including 7 meta-analyses or systematic reviews and 5 randomized studies. Snowball search identified 11 additional studies providing topical information. Overall, tumor necrosis factor inhibitors likely do not increase the risk of postoperative adverse outcomes, while data on other biologics and small-molecule agents are emerging.This is a qualitative review including all study types. The varied nature of study types precludes quantitative comparison.Although steroids increase postoperative infectious and noninfectious complications, tumor necrosis factor inhibitors do not appear to increase postoperative infectious and noninfectious complications. There is a need for further perioperative data for other agents. See video from symposium .

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Published In

Diseases of the colon and rectum

DOI

EISSN

1530-0358

ISSN

0012-3706

Publication Date

June 2024

Volume

67

Issue

S1

Start / End Page

S11 / S25

Related Subject Headings

  • Tumor Necrosis Factor Inhibitors
  • Surgical Wound Infection
  • Surgery
  • Reoperation
  • Pyrimidines
  • Postoperative Complications
  • Piperidines
  • Length of Stay
  • Inflammatory Bowel Diseases
  • Humans
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Lee, K. E., Sizemore, J. A., Kim, G., Shen, B., & Sands, B. E. (2024). Impact of Biologics and Small-Molecule Agents on Postoperative Complications in IBD: A Systematic Review. Diseases of the Colon and Rectum, 67(S1), S11–S25. https://doi.org/10.1097/dcr.0000000000003222
Lee, Kate E., J Alexander Sizemore, Grace Kim, Bo Shen, and Bruce E. Sands. “Impact of Biologics and Small-Molecule Agents on Postoperative Complications in IBD: A Systematic Review.Diseases of the Colon and Rectum 67, no. S1 (June 2024): S11–25. https://doi.org/10.1097/dcr.0000000000003222.
Lee KE, Sizemore JA, Kim G, Shen B, Sands BE. Impact of Biologics and Small-Molecule Agents on Postoperative Complications in IBD: A Systematic Review. Diseases of the colon and rectum. 2024 Jun;67(S1):S11–25.
Lee, Kate E., et al. “Impact of Biologics and Small-Molecule Agents on Postoperative Complications in IBD: A Systematic Review.Diseases of the Colon and Rectum, vol. 67, no. S1, June 2024, pp. S11–25. Epmc, doi:10.1097/dcr.0000000000003222.
Lee KE, Sizemore JA, Kim G, Shen B, Sands BE. Impact of Biologics and Small-Molecule Agents on Postoperative Complications in IBD: A Systematic Review. Diseases of the colon and rectum. 2024 Jun;67(S1):S11–S25.

Published In

Diseases of the colon and rectum

DOI

EISSN

1530-0358

ISSN

0012-3706

Publication Date

June 2024

Volume

67

Issue

S1

Start / End Page

S11 / S25

Related Subject Headings

  • Tumor Necrosis Factor Inhibitors
  • Surgical Wound Infection
  • Surgery
  • Reoperation
  • Pyrimidines
  • Postoperative Complications
  • Piperidines
  • Length of Stay
  • Inflammatory Bowel Diseases
  • Humans