Evidence map›Paper›PMID 31294352›Full record

ArticleJournal of the Canadian Association of Gastroenterology2018

Preoperative Ustekinumab Treatment Is Not Associated With Increased Postoperative Complications in Crohn's Disease: A Canadian Multi-Centre Observational Cohort Study.

Hang Hock Shim, Christopher Ma, Paulo G Kotze, Cynthia H Seow, Heba Al-Farhan, Ahmed K Al-Darmaki, Jack X Q Pang, Richard N Fedorak, Shane M Devlin, Levinus A Dieleman and 5 more

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of the Canadian Association of Gastroenterology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
23citing papers in PubMed, 4 pooled it
3.3field-weighted citation impact, top 8% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

23 citing papers in PubMed, 4 syntheses or guidelines pooled it, 27 citations in OpenAlex.

  1. Systematic Review and Meta-Analysis: Association between Preoperative Ustekinumab and Surgical Complications in Crohn's Disease Patients.European surgical research. Europaische chirurgische Forschung. Recherches chirurgicales europeennes · 2023
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  10. Perioperative optimization of Crohn's disease.Annals of gastroenterological surgery · 2023
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  18. Surgery for Inflammatory Bowel Disease in the Era of Biologics.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2020
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors at 2 institutions in 1 country.

Hang Hock ShimDivision of Gastroenterology and Hepatology, University of Calgary, Calgary, Canada.
Christopher MaDivision of Gastroenterology and Hepatology, University of Calgary, Calgary, Canada.ORCID 0000-0002-4698-9948
Paulo G KotzeDivision of Gastroenterology and Hepatology, University of Calgary, Calgary, Canada.
Cynthia H SeowDivision of Gastroenterology and Hepatology, University of Calgary, Calgary, Canada.ORCID 0000-0002-1551-9054
Heba Al-FarhanDivision of Gastroenterology and Hepatology, University of Calgary, Calgary, Canada.
Ahmed K Al-DarmakiDivision of Gastroenterology and Hepatology, University of Calgary, Calgary, Canada.
Jack X Q PangDivision of Gastroenterology and Hepatology, University of Calgary, Calgary, Canada.
Richard N FedorakDivision of Gastroenterology, University of Alberta, Edmonton, Canada.
Shane M DevlinDivision of Gastroenterology and Hepatology, University of Calgary, Calgary, Canada.
Levinus A DielemanDivision of Gastroenterology, University of Alberta, Edmonton, Canada.
Gilaad G KaplanDivision of Gastroenterology and Hepatology, University of Calgary, Calgary, Canada.
Kerri L NovakDivision of Gastroenterology and Hepatology, University of Calgary, Calgary, Canada.
Karen I KroekerDivision of Gastroenterology, University of Alberta, Edmonton, Canada.
Brendan P HalloranDivision of Gastroenterology, University of Alberta, Edmonton, Canada.
Remo PanaccioneDivision of Gastroenterology and Hepatology, University of Calgary, Calgary, Canada.
University of Calgary · CAUniversity of Alberta · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundUstekinumab (UST), an anti-IL12/23 inhibitor is indicated for moderate-to-severe Crohn's disease (CD). However, it is unclear if patients treated with UST are at increased risk for postoperative complications.

aimTo evaluate the postoperative safety outcomes in UST-treated CD patients.

methodsA multicentre cohort study of UST-treated CD patients at two tertiary care centres (University of Calgary, University of Alberta, Canada) undergoing abdominal surgery between 2009 and 2016 was performed. Postoperative outcomes were compared against a control cohort of anti-TNF-treated patients over the same time-period. The primary outcome was occurrence of postoperative complications up to six months postoperatively, stratified by timing (early <30 days vs. late complications ≥30 days).

resultsTwenty UST-treated patients and 40 anti-TNF-treated patients were included with a median preoperative treatment exposure of 6.5 months and 18 months, respectively (p=0.01). Bowel obstruction was the most common surgical indication in both cohorts. UST-treated patients were more likely to require an ostomy (70.0% vs. 12.5%, p<0.001) and be on combination therapy with either systemic corticosteroids or concurrent immunomodulators (azathioprine or methotrexate) (25.0% vs. 2.5%, p=0.01). Despite the increased concomitant use of immunosuppression in the UST-treated cohort, there were no significant differences in early or late postoperative wound infections (1/20 in UST-cohort, 2/40 in anti-TNF cohort, p=1.00), anastomotic leak (0/20 in UST-cohort, 3/40 in anti-TNF cohort, p=0.54), or postoperative ileus/obstruction (3/20 in UST-cohort, 4/40 in anti-TNF cohort, p=0.67).

conclusionsCD patients receiving preoperative UST did not experience an increase in postoperative complications, despite increased use of concurrent immunosuppression.

Indexed as

Crohn’s diseasePostoperative complicationsSurgeryUstekinumab

Identifiers

PMID31294352
PMCPMC6507292
OpenAlexW2607220660

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.