Evidence map›Paper›PMID 36942657›Full record

ArticleUnited European gastroenterology journal2023

Comparison of two strategies for the management of postoperative recurrence in Crohn's disease patients with one clinical risk factor: A multicentre IG-IBD study.

Gabriele Dragoni, Fabiana Castiglione, Cristina Bezzio, Daniela Pugliese, Rocco Spagnuolo, Anna Viola, Francesco Cocomazzi, Annalisa Aratari, Edoardo Vincenzo Savarino, Paola Balestrieri and 11 more

Open access · hybridAbstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in United European gastroenterology journal, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
3.4field-weighted citation impact, top 7% 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

6 citing papers in PubMed, 11 citations in OpenAlex.

  1. Review
  2. Review
  3. Review
  4. Review
  5. Article
  6. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

21 authors at 15 institutions in 3 countries.

Gabriele DragoniIBD Referral Center, Department of Gastroenterology, Careggi University Hospital, Florence, Italy.ORCID 0000-0001-5752-5113
Fabiana CastiglioneGastroenterology, Department of Clinical Medicine and Surgery, AOU Federico II Napoli, Napoli, Italy.
Cristina BezzioIBD Center, Gastroenterology Unit, Rho Hospital, ASST Rhodense, Milan, Italy.
Daniela PuglieseCEMAD - IBD UNIT, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy.
Rocco SpagnuoloDepartment of Health Science, Magna Graecia University, Catanzaro, Italy.ORCID 0000-0002-0871-4644
Anna ViolaIBD-Unit, Department. of Clinical and Experimental Medicine, University of Messina, Messina, Italy.ORCID 0000-0002-1733-6489
Francesco CocomazziDepartment of Gastroenterology and Endoscopy, Fondazione "Casa Sollievo della Sofferenza", IRCCS, San Giovanni Rotondo, Italy.
Annalisa AratariIBD Unit, San Filippo Neri Hospital, Rome, Italy.
Edoardo Vincenzo SavarinoInflammatory Bowel Disease Unit-Azienda Ospedaliera-University of Padua, Padua, Italy.
Paola BalestrieriGastroenterology Unit, Campus Bio-Medico University, Rome, Italy.
Sara OnaliDepartment of Medical Science and Public Health, Gastroenterology Unit, University of Cagliari, Cagliari, Italy.
Chiara ViganòDepartment of Gastroenterology and Center for Autoimmune Liver Diseases, European Reference Network on Hepatological Diseases (ERN RARE-LIVER), Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy.
Davide Giuseppe RibaldoneDepartment of Medical Sciences, University of Turin, Turin, Italy.ORCID 0000-0002-9421-3087
Tommaso InnocentiIBD Referral Center, Department of Gastroenterology, Careggi University Hospital, Florence, Italy.
Anna TestaGastroenterology, Department of Clinical Medicine and Surgery, AOU Federico II Napoli, Napoli, Italy.
Simone SaibeniIBD Center, Gastroenterology Unit, Rho Hospital, ASST Rhodense, Milan, Italy.ORCID 0000-0001-5677-2534
Giuseppe PriviteraCEMAD - IBD UNIT, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy.ORCID 0000-0002-7020-5808
Monica MillaIBD Referral Center, Department of Gastroenterology, Careggi University Hospital, Florence, Italy.
Alessandro ArmuzziIBD Center, IRCCS Humanitas Research Hospital, Milan, Italy.
Massimo Claudio FantiniDepartment of Medical Science and Public Health, Gastroenterology Unit, University of Cagliari, Cagliari, Italy.
Gionata FiorinoGastroenterology and Endoscopy, IRCCS Ospedale San Raffaele and University Vita-Salute San Raffaele, Milan, Italy.ORCID 0000-0001-5623-2968
Azienda Ospedaliero-Universitaria Careggi · ITFederico II University Hospital · ITGeneral Hospital of Rhodes · GRIstituti di Ricovero e Cura a Carattere Scientifico · ITUniversity of Cagliari · ITAzienda Ospedaliera San Gerardo · ITCasa Sollievo della Sofferenza · ITHumanitas University · ITIRCCS Ospedale San Raffaele · ITMagna Graecia University · ITOspedale San Filippo Neri · ITUniversità Campus Bio-Medico · ITUniversity of Messina · ITUniversity of Padua · ITUniversity of Turin · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe management of postoperative recurrence (POR) in Crohn's disease (CD) after ileo-colonic resection is a highly debated topic. Prophylactic immunosuppression after surgery is currently recommended in the presence of at least one clinical risk factor.

objectiveOur aim was to determine whether early immunosuppression can be avoided and guided by endoscopy in CD patients with only one risk factor.

methodsCD patients with only one risk factor for POR, including previous intestinal resection, extensive small intestine resection (>50 cm), fistulising phenotype, history of perianal disease, and active smoking, were retrospectively included. Two groups were formed based on whether immunosuppression was started immediately after surgery ("prophylaxis group") or guided by endoscopy ("endoscopy-driven group"). Primary endpoints were rates of any endoscopic recurrence (Rutgeerts ≥ i2a) and severe endoscopic recurrence (i4) within 12 months after surgery. Secondary outcomes were clinical recurrence rates at 6, 12 and 24 months after surgery.

resultsA total of 195 patients were enroled, of whom 61 (31.3%) received immunoprophylaxis. No differences between immunoprophylaxis and the endoscopy-driven approach were found regarding any endoscopic recurrence (36.1% vs. 45.5%, respectively, p = 0.10) and severe endoscopic recurrence (9.8% vs. 15.7%, respectively, p = 0.15) at the first endoscopic evaluation. Clinical recurrence rates were also not statistically different (p = 0.43, p = 0.09, and p = 0.63 at 6, 12, and 24 months, respectively).

conclusionsIn operated CD patients with only one risk factor for POR, immediate immunoprophylaxis does not decrease the rate of early clinical and endoscopic recurrence. Prospective studies are needed to confirm our results.

Indexed as

Crohn DiseaseColonColonoscopyHumansNeoplasm Recurrence, LocalRetrospective StudiesCrohn's diseaseendoscopic recurrenceileo-colonic resectionimmunoprophylaxisinflammatory bowel diseasepostoperative Crohn's diseasepostoperative recurrenceRutgeerts Score

Identifiers

PMID36942657
PMCPMC10083469
OpenAlexW4328049012

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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.