Evidence map›Paper›PMID 40624415›Full record

ArticleSurgical endoscopy2025

Exposure to advanced therapies and risk of surgery in Crohn's disease.

Marc M Mankarious, Kara Dijoseph, Alicia C Greene, Eric W Schaefer, Kofi Clarke, Michael J Deutsch, Jeffrey S Scow, Afif N Kulaylat, Audrey S Kulaylat

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Surgical endoscopy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. Article
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

9 authors.

Marc M MankariousDepartment of Surgery, Pennsylvania State University, College of Medicine, Hershey, PA, USA.
Kara DijosephDivision of Gastroenterology & Hepatology, Department of Medicine, Pennsylvania State University, Hershey, PA, USA.
Alicia C GreeneDepartment of Surgery, Pennsylvania State University, College of Medicine, Hershey, PA, USA.
Eric W SchaeferDepartment of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA.
Kofi ClarkeDivision of Gastroenterology & Hepatology, Department of Medicine, Pennsylvania State University, Hershey, PA, USA.
Michael J DeutschDivision of Colon and Rectal Surgery, Department of Surgery, Pennsylvania State University, Hershey, PA, USA.
Jeffrey S ScowDivision of Colon and Rectal Surgery, Department of Surgery, Pennsylvania State University, Hershey, PA, USA.
Afif N KulaylatDepartment of Surgery, Pennsylvania State University, College of Medicine, Hershey, PA, USA.
Audrey S KulaylatDivision of Colon and Rectal Surgery, Department of Surgery, Pennsylvania State University, Hershey, PA, USA. AKulaylat1@pennstatehealth.psu.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND &

aimsWhile advancements in therapeutic options for inflammatory bowel disease reduced rates of surgical resection, some patients still require surgery despite multiple lines of medical therapies. This study investigates the relationship between the number, class, and progression rate of different advanced therapies (AT) and risk of surgical resection and postoperative complications in patients with Crohn's Disease (CD).

methodsThis study is a retrospective cohort study utilizing the MarketScan database, including adult patients with CD on AT from 2005 to 2020. The number of AT, class of AT, and comorbidities were assessed for all patients. The primary endpoint was surgical resection. A time-varying Cox proportional hazards regression model was used to assess risk of surgical resection. Logistic regression was used to assess secondary outcomes, including postoperative complications, readmissions, and emergency department (ED) visits.

resultsThe sample included 15,547 patients of whom 10.6% required surgical resection at some point. Use of anti-integrin therapy as first line was associated with higher risk of surgery compared to TNF-alpha inhibitors (Hazard ratio [HR] 1.39, p < 0.05). Utilization of 2, 3, or ≥ 4 AT was associated with increased surgery risk (HRs of 2.80, 4.54, and 7.82, respectively, p < 0.001). The number and class of ATs were not associated with postoperative complications, readmissions, or ED visits.

conclusionUse of first-line anti-integrin was associated with higher risk of surgery and thus our study supports the use of TNF-alpha inhibitors as the first-line therapy in treatment-naïve patients. Nevertheless, multidisciplinary care is crucial in identifying and counseling patients at risk of surgery.

Indexed as

Crohn DiseaseDigestive System Surgical ProceduresPostoperative ComplicationsAdultFemaleHumansMaleMiddle AgedPatient ReadmissionRetrospective StudiesRisk AssessmentYoung AdultBiologicsCrohn’s diseaseMarketScanPostoperative complicationsSurgical resection

Identifiers

PMID40624415
PMCPMC12287203

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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.