Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions
Surgery vs Infliximab for Crohn’s Disease
Lancet Gastroenterol Hepatol; 2017 Nov; Ponsioen, et al
When patients with ileocecal Crohn’s disease don’t respond to conventional treatment, biological agents are usually considered, but a recent randomized clinical trial suggests surgery is a viable option.
- A randomized, controlled open-label study that included 29 teaching hospitals and tertiary care centers compared infliximab to laparoscopic ileocecal resection in patients with non-stricturing ileocecal Crohn’s disease.
- Quality of life score, as measured by the Inflammatory Bowel Disease Questionnaire (IBDQ), was 178.1 at 12 months in surgical patients, compared to 172 in patients on infliximab.
- Results for the Short-Form-36, another measure of quality of life, was 112.1 in the group undergoing surgery compared to 106.5.
- The results suggest surgery is a reasonable alternative to biologic agents, according to investigators.
Citation:
Ponsioen CY, de Groof EJ, Eshuis EJ, et al. Laparoscopic ileocaecal resection versus infliximab for terminal ileitis in Crohn's disease: A randomised controlled, open-label, multicentre trial. Lancet Gastroenterol Hepatol. 2017;11:785-792. doi:10.1016/S2468-1253(17)30248-0.