Cookies on this website

We use cookies to ensure that we give you the best experience on our website. If you click 'Accept all cookies' we'll assume that you are happy to receive all cookies and you won't see this message again. If you click 'Reject all non-essential cookies' only necessary cookies providing core functionality such as security, network management, and accessibility will be enabled. Click 'Find out more' for information on how to change your cookie settings.

BackgroundA laparoscopic ileocolic resection could lead to a better outcome to infliximab for ileocolic Crohn's disease. The aim of this study was to explore real world clinical outcomes in biologic-naïve patients with ileocolic Crohn's disease.Research design and methodsAll patients with ileocolic Crohn's disease treated at our institution between January 2011 and December 2018 with biologics or surgical resection were included.ResultsOverall, 222 patients were included, of which 149 (67%) underwent surgery before biologic therapy. Among these, 54 patients (36%) required post-operative biologic therapy. Seventy-three patients were treated with biologics first, of which 29 (40%) subsequently required a surgical resection (p = 0.60). There were 95 patients (43%) who were successfully treated with a surgery-first approach alone. Median follow-up was 73 months (0-406). Characteristics associated on multivariable analysis with change from surgery to biologics were: gender (female) (p = 0.010), presence of obstructive symptoms (p = 0.028), and smoking (p = 0.030). Characteristics associated with changing from biologics to surgery were: isolated terminal ileum disease (p = 0.001) and the presence of obstructive symptoms (p = 0.003).ConclusionsIn our cohort, the risk of recurrent ileocolic Crohn's disease was similar whether patients were treated with a 'surgery first' or 'biologic first' approach.

Original publication

DOI

10.1080/17474124.2025.2519167

Type

Journal article

Journal

Expert review of gastroenterology & hepatology

Publication Date

07/2025

Volume

19

Pages

817 - 824

Addresses

Department of Colorectal Surgery, Oxford University Hospital, NHS Foundation Trust, Oxford, UK.

Keywords

Ileum, Humans, Crohn Disease, Gastrointestinal Agents, Biological Products, Laparoscopy, Treatment Outcome, Biological Therapy, Colectomy, Retrospective Studies, Adult, Middle Aged, Female, Male, Young Adult, Infliximab