Biologic use before surgery not linked with increased infections
Biologic therapy exposure within 60 days of inflammatory bowel disease-related surgery did not confer a risk for post-operative infectious or surgical site complications, according to research presented at the Crohn’s and Colitis Congress.
“We’re all aware that earlier reports from multiple studies suggested that biologics before surgery are associated with increased post-operative morbidity, but it’s been controversial in the last couple of years,” Steven David Holubar, MD, from Cleveland Clinic, said in his presentation. “We aimed to assess potential associations between preoperative biologic exposure and post-operative infectious complications using a large, nationally-representative cohort.”
Researchers analyzed data from the American College of Surgeon National Surgical Quality Improvement Program IBD Collaborative.
The primary endpoint of the study was any infectious complication, and the secondary endpoint was any surgical site infection. Researchers assessed the association after adjusting for diagnosis, chronic steroid use, immunomodulator use and other variables.
Out of 1,562 total patients in the study, 832 were not exposed to biologics and 730 were.
Compared with no biologic use, biologic exposure was not associated with any infectious complications or surgical sire infections. However, it was linked with increased rate of anastomotic leak after proctectomy.
In their multivariate analysis, investigators found that biologics were not associated with any infectious complication (OR = .088; 95% CI, 0.54-1.42) or any surgical site complication (OR = 0.77; 95% CI, 0.46-1.28). Crohn’s disease was associated with infectious complication (OR = 2.11; 95% CI, 1.12-4).
“This is likely due to the judicious use of ileostomies,” Holubar said.