{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T13:04:34Z","timestamp":1790687074400,"version":"4.1.0"},"reference-count":23,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2022,9,18]],"date-time":"2022-09-18T00:00:00Z","timestamp":1663459200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,3,18]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>The modified Rutgeerts\u2019 score [RS] differentiates i2a\u2014lesions confined to the anastomosis\u2014and i2b\u2014more than five aphthous ulcers in the neoterminal ileum with normal intervening mucosa, with or without anastomotic lesions\u2014categories. Its relevance for the therapeutic management of Crohn\u2019s disease [CD] patients after ileocolic resection is still debated. Our objective was to compare the postoperative recurrence risk in patients with an i2a or i2b score, using an individual patient data meta-analysis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We conducted a systematic literature search until July 2020, to identify all relevant studies reporting the i2a\/i2b status in the year following ileocolic resection and clinical and\/or surgical postoperative CD recurrence in their follow-up. Individual patient-level data were obtained from the corresponding authors. The association between the modified RS and time-to-event was evaluated using a mixed Cox model with the centre as the random effect.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Seven studies published between 2008 and 2019 were included, corresponding to 400 patients: 189 [47%] i2a and 211 [53%] i2b. Median [interquartile range, IQR] time from ileocolic resection to ileocolonoscopy was 6.2 [5.5, 7.9] months and median [IQR] follow-up time after ileocolonoscopy was 4.5 [2.9, 7.3] years. The risk of clinical postoperative recurrence at 1 and 3 years was 11% [6\u201315%], and 25% [18\u201332%] in the i2a group versus 9% [5\u201313%] and 33% [26\u201341%] in the i2b group [p\u2005=\u20050.63 and p\u2005=\u20050.12, respectively]. No significant difference was observed in terms of time to clinical postoperative recurrence [p\u2005=\u20050.16] or surgical postoperative recurrence [p\u2005=\u20050.87]. Results did not change after excluding patients having initiated an immunosuppressant or a biologic in the 3 months after endoscopy [remaining cohort, n\u2005=\u2005361].<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>In this individual patient data meta-analysis, no difference was observed between i2a and i2b subcategories with regards to clinical or surgical postoperative recurrence. As we wait for prospective trials, the same treatment strategy could be applied to all patients classified as i2 on the Rutgeerts score.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ecco-jcc\/jjac137","type":"journal-article","created":{"date-parts":[[2022,9,20]],"date-time":"2022-09-20T09:23:30Z","timestamp":1663665810000},"page":"269-276","source":"Crossref","is-referenced-by-count":37,"title":["Comparison of the Risk of Crohn\u2019s Disease Postoperative Recurrence Between Modified Rutgeerts Score i2a and i2b Categories: An Individual Patient Data Meta-analysis"],"prefix":"10.1093","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1262-2806","authenticated-orcid":false,"given":"Pauline","family":"Rivi\u00e8re","sequence":"first","affiliation":[{"name":"H\u00f4pital Haut-L\u00e9v\u00eaque, Service d\u2019H\u00e9pato-gastroent\u00e9rologie et oncologie digestive \u2013 Universit\u00e9 de Bordeaux , Bordeaux , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joel","family":"Pekow","sequence":"additional","affiliation":[{"name":"Gastroenterology Department, University of Chicago , Chicago, IL , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nassim","family":"Hammoudi","sequence":"additional","affiliation":[{"name":"Service d\u2019H\u00e9pato-gastroent\u00e9rologie, H\u00f4pital Saint-Louis, Universit\u00e9 de Paris , Paris , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pauline","family":"Wils","sequence":"additional","affiliation":[{"name":"Univ. Lille, Institute for Translational Research \u00a0 in Inflammation, Lille , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"De Cruz","sequence":"additional","affiliation":[{"name":"Gastroenterology Department, Austin Health , Heidelberg, VIC , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina Pu","family":"Wang","sequence":"additional","affiliation":[{"name":"Dr Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai , New York, NY , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M\u00edriam","family":"Ma\u00f1osa","sequence":"additional","affiliation":[{"name":"Hospital Universitari Germans Trias i Pujol , Badalona, Catalunya , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacob","family":"Ollech","sequence":"additional","affiliation":[{"name":"Gastroenterology Department, University of Chicago , Chicago, IL , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthieu","family":"Allez","sequence":"additional","affiliation":[{"name":"Service d\u2019H\u00e9pato-gastroent\u00e9rologie, H\u00f4pital Saint-Louis, Universit\u00e9 de Paris , Paris , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Nachury","sequence":"additional","affiliation":[{"name":"Univ. Lille, Institute for Translational Research \u00a0 in Inflammation, Lille , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael A","family":"Kamm","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, St Vincent\u2019s Hospital , Melbourne, VIC , Australia"},{"name":"Department of Medicine, University of Melbourne , Melbourne, VIC , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maya","family":"Ahanori","sequence":"additional","affiliation":[{"name":"Gastroenterology Department, University of Chicago , Chicago, IL , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1492-0716","authenticated-orcid":false,"given":"Marc","family":"Ferrante","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, University Hospitals Leuven, KU Leuven , Leuven , Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6347-409X","authenticated-orcid":false,"given":"Anthony","family":"Buisson","sequence":"additional","affiliation":[{"name":"Service d\u2019H\u00e9pato-gastroent\u00e9rologie, Centre Hospitalier Universitaire \u00a0 de Clermont-Ferrand, Clermont-Ferrand , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siddarth","family":"Singh","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Division of Biomedical Informatics, Department of Medicine, University of California San Diego , La Jolla, CA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Laharie","sequence":"additional","affiliation":[{"name":"H\u00f4pital Haut-L\u00e9v\u00eaque, Service d\u2019H\u00e9pato-gastroent\u00e9rologie et oncologie digestive \u2013 Universit\u00e9 de Bordeaux , Bordeaux , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Momar","family":"Diouf","sequence":"additional","affiliation":[{"name":"Direction de la recherche clinique, Centre Hospitalier Universitaire Amiens-Picardie \u00a0 Site Sud , Amiens , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathurin","family":"Fumery","sequence":"additional","affiliation":[{"name":"Service d\u2019H\u00e9pato-gastroent\u00e9rologie, Centre Hospitalier Universitaire Amiens-Picardie \u00a0 Site Sud , Amiens , France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,9,18]]},"reference":[{"key":"2023052615095730900_CIT0001","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1038\/ajg.2009.579","article-title":"The natural history of adult Crohn\u2019s disease in population-based cohorts","volume":"105","author":"Peyrin-Biroulet","year":"2010","journal-title":"Am J Gastroenterol"},{"key":"2023052615095730900_CIT0002","doi-asserted-by":"crossref","first-page":"2031","DOI":"10.1016\/j.cgh.2020.10.039","article-title":"Contemporary risk of surgery in patients with ulcerative colitis and Crohn\u2019s disease: a meta-analysis of population-based cohorts","volume":"19","author":"Tsai","year":"2021","journal-title":"Clin Gastroenterol Hepatol"},{"key":"2023052615095730900_CIT0003","doi-asserted-by":"crossref","first-page":"1529","DOI":"10.1002\/bjs.11659","article-title":"Decrease in primary but not in secondary abdominal surgery for Crohn\u2019s disease: nationwide cohort study, 1990-2014","volume":"107","author":"Kalman","year":"2020","journal-title":"Br J Surg"},{"key":"2023052615095730900_CIT0004","doi-asserted-by":"crossref","first-page":"956","DOI":"10.1016\/0016-5085(90)90613-6","article-title":"Predictability of the postoperative course of Crohn\u2019s disease","volume":"99","author":"Rutgeerts","year":"1990","journal-title":"Gastroenterology"},{"key":"2023052615095730900_CIT0005","doi-asserted-by":"crossref","first-page":"625","DOI":"10.1111\/j.1365-2036.2012.05002.x","article-title":"Review article: the natural history of postoperative Crohn\u2019s disease recurrence","volume":"35","author":"Buisson","year":"2012","journal-title":"Aliment Pharmacol Ther"},{"key":"2023052615095730900_CIT0006","doi-asserted-by":"crossref","first-page":"1406","DOI":"10.1016\/S0140-6736(14)61908-5","article-title":"Crohn\u2019s disease management after intestinal resection: a randomised trial","volume":"385","author":"De Cruz","year":"2015","journal-title":"Lancet"},{"key":"2023052615095730900_CIT0007","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1093\/ecco-jcc\/jjw169","article-title":"Third European evidence-based consensus on the diagnosis and management of Crohn\u2019s disease 2016. 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