Risk of post-operative complications associated with anti-TNF therapy in inflammatory bowel disease

Table 1 Crohn’s disease study characteristics

Author study center	Study design	Total patients	Study endpoints	Concomitant medication	Case (%)	Control (%)	P value	IFX dosing	Last dose IFX prior to surgery < 12 wk (%)
Marchal[22], 2004, Belgium	Case-control	79 total, 40 cases, 39 controls	Early (10 d) and late (3 mo) complications	5-ASA	30	54	N.S.	Episodic 100%	78
				6MP/AZA	45	26	N.S.
				Steroids	73	41	< 0.00017
				Antibiotics	25	28	N.S.
Colombel[23], 2004, Mayo Clinic, Rochester	Retrospective	270 total, 52 cases	Early (30 d) septic and non-septic complications	5-ASA	-	-	-	Episodic 80%	96
				6MP/AZA	7	-	-
				Steroids	7	-	-
				Antibiotics	-	-	-
Appau[24] , 2008, Cleveland Clinic, Cleveland	Case-control	458 total, 329 Non IFX, 60 IFX, 69 pre IFX	30 d post-operative complications	5-ASA	60	58	0.95	-	100
				6MP/AZA	62	15	< 0.001
				Steroids	65	77	< 0.052
				Antibiotics	-	-	-
Kunitake[29], 2008, Massachusetts General Hospital, Boston (combined study)	Case-control	413 total, 101 cases, 312 control	Post-operative complications	5-ASA	-	-	-	-	100
				6MP/AZA	37	6	0.04
				Steroids	75.30	77	0.79
				Antibiotics	-	-	-

IFX: Infliximab; 5-ASA: 5-aminosalicylic acid; AZA: Azathioprine; 6MP: 6-mercaptopurine; N.S.: Not significant.