{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T22:46:09Z","timestamp":1793400369478,"version":"4.5.0"},"reference-count":33,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2021,5,5]],"date-time":"2021-05-05T00:00:00Z","timestamp":1620172800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["UEG Journal"],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Preventing postoperative recurrence (POR) is a major concern in Crohn's disease (CD). While azathioprine is an option, no data is available on ustekinumab efficacy in this situation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>We compared the effectiveness of ustekinumab versus azathioprine in preventing endoscopic POR in CD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively collected data from all consecutive CD patients treated with ustekinumab after intestinal resection in 9 centers. The control group (azathioprine alone) was composed of patients who participated in a randomized controlled trial conducted in the same centers comparing azathioprine alone or in combination with curcumin. Propensity score analyses (inversed probability of treatment weighting\u00a0=\u00a0IPTW) were applied to compare the two groups. The primary endpoint was endoscopic POR (Rutgeerts' index\u00a0\u2265\u00a0i2) at 6\u00a0months.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall, 32 patients were included in the ustekinumab group and 31 in the azathioprine group. The propensity score analysis was adjusted on the main risk factors (smoking, fistulizing phenotype, prior bowel resection, resection length &gt;30\u00a0cm and \u22652 biologics before surgery) and thiopurines or ustekinumab exposure prior to surgery making the two arms comparable (\u2223d\u2223 &lt; 0.2). After IPTW, the rate of endoscopic POR at 6\u00a0months was lower in patients treated with ustekinumab compared to azathioprine (28.0% vs. 54.5%, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.029). After IPTW, the rates of i2b\u2010endoscopic POR (Rutgeerts' index\u00a0\u2265\u00a0i2b) and severe endoscopic POR (Rutgeerts' index\u00a0\u2265\u00a0i3) were 20.8% versus 42.5% (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.066) and 16.9% versus 27.9% (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.24), in the ustekinumab and azathioprine groups, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Ustekinumab seemed to be more effective than azathioprine in preventing POR in this cohort of CD patients.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ueg2.12068","type":"journal-article","created":{"date-parts":[[2021,5,6]],"date-time":"2021-05-06T16:15:38Z","timestamp":1620317738000},"page":"552-560","source":"Crossref","is-referenced-by-count":51,"title":["Ustekinumab is more effective than azathioprine to prevent endoscopic postoperative recurrence in Crohn's disease"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6347-409X","authenticated-orcid":false,"given":"Anthony","family":"Buisson","sequence":"first","affiliation":[{"name":"Universit\u00e9 Clermont Auvergne Inserm, 3iHP CHU Clermont\u2010Ferrand Service d\u2019H\u00e9pato\u2010Gastroent\u00e9rologie  Clermont\u2010Ferrand France"},{"name":"Universit\u00e9 Clermont Auvergne Inserm U1071 M2iSH USC\u2010INRA 2018  Clermont\u2010Ferrand France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"St\u00e9phane","family":"Nancey","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Hospices Civils de Lyon Lyon\u2010Sud Hospital Pierre B\u00e9nite, and INSERM U1111 \u2013 CIRI  Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luc","family":"Manlay","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Clermont Auvergne Inserm, 3iHP CHU Clermont\u2010Ferrand Service 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