Ed Loftus, M. D., discusses a recent study published in The American Journal of Gastroenterology that examines if medications after surgery can effectively prevent reoccurrence of Crohn's disease. Many patients find surgery to be beneficial in managing quality of life if they have obstructive symptoms, but many patients will have recurring symptoms.
This study took place in Italy and examined 51 patients randomized into three groups. All of the patients had undergone an ileocolonic resection for their Crohn's disease. Group one received adalimumab at 160 mg baseline, 80 mg 2 weeks later, and then 40 mg every 2 weeks. Group two received azathioprine at 2 mg per 1 kg of body weight. Group three received 3 g daily of mesalamine. The patients were studied over a period of two years and then underwent a colonoscopy to see if there was evidence of recurrence. Only 6% of the adalimumab patients had an endoscopic reoccurrence compared to 64% of the azathioprine treated patients and 83% of the mesalamine treated patients.
These results are similar to the results of a study done by Dr. Regueiro at the University of Pittsburgh looking at infliximab for post-operative Crohn's disease. These two studies provide an encouraging outlook that anti-TNF therapy may be the single best medicine to prevent recurrence of Crohn's disease after surgery.
Full text of the article can be viewed here.
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Dr. Loftus is a clinical gastroenterologist at the Mayo Clinic specializing in the care of patients with Crohn's disease and ulcerative colitis.