{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T10:11:55Z","timestamp":1787825515944,"version":"build-2784847793"},"reference-count":51,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2015,8,28]],"date-time":"2015-08-28T00:00:00Z","timestamp":1440720000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100000925","name":"NHMRC","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2015,10]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Crohn's disease recurs in the majority of patients after intestinal resection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To compare the relative efficacy of thiopurines and anti\u2010TNF therapy in patients at high risk of disease recurrence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>As part of a larger study comparing post\u2010operative management strategies, patients at high risk of recurrence (smoker, perforating disease, \u22652nd operation) were treated after resection of all macroscopic disease with 3\u00a0months metronidazole together with either azathioprine 2\u00a0mg\/kg\/day or mercaptopurine 1.5\u00a0mg\/kg\/day. Thiopurine\u2010intolerant patients received adalimumab induction then 40\u00a0mg fortnightly. Patients underwent colonoscopy at 6\u00a0months with endoscopic recurrence assessed blind to treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 101 patients [50% male; median (IQR) age 36 (25\u201346) years] were included. There were no differences in disease history between thiopurine\u2010 and adalimumab\u2010treated patients. Fifteen patients withdrew prior to 6\u00a0months, five due to symptom recurrence (of whom four were colonoscoped). Endoscopic recurrence (Rutgeerts score i2\u2013i4) occurred in 33 of 73 (45%) thiopurine vs. 6 of 28 (21%) adalimumab\u2010treated patients [intention\u2010to\u2010treat (ITT); <jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.028] or 24 of 62 (39%) vs. 3 of 24 (13%) respectively [per\u2010protocol analysis (PPA); <jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.020]. Complete mucosal endoscopic normality (Rutgeerts i0) occurred in 17\/73 (23%) vs. 15\/28 (54%) (ITT; <jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.003) and in 27% vs. 63% (PPA; <jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.002). The most advanced disease (Rutgeerts i3 and i4) occurred in 8% vs. 4% (thiopurine vs. adalimumab).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In Crohn's disease patients at high risk of post\u2010operative recurrence adalimumab is superior to thiopurines in preventing early disease recurrence.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.13353","type":"journal-article","created":{"date-parts":[[2015,8,28]],"date-time":"2015-08-28T07:59:40Z","timestamp":1440748780000},"page":"867-879","source":"Crossref","is-referenced-by-count":128,"title":["Efficacy of thiopurines and adalimumab in preventing Crohn's disease recurrence in high\u2010risk patients \u2013 a POCER study analysis"],"prefix":"10.1111","volume":"42","author":[{"given":"P.","family":"De Cruz","sequence":"first","affiliation":[{"name":"St Vincent's Hospital and University of Melbourne Melbourne Vic."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. A.","family":"Kamm","sequence":"additional","affiliation":[{"name":"St Vincent's Hospital and University of Melbourne Melbourne Vic."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. L.","family":"Hamilton","sequence":"additional","affiliation":[{"name":"St Vincent's Hospital and University of Melbourne Melbourne Vic."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K. J.","family":"Ritchie","sequence":"additional","affiliation":[{"name":"St Vincent's Hospital Melbourne"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E. O.","family":"Krejany","sequence":"additional","affiliation":[{"name":"St Vincent's Hospital and University of Melbourne Melbourne Vic."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Gorelik","sequence":"additional","affiliation":[{"name":"Melbourne EpiCentre Royal Melbourne Hospital Melbourne"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Liew","sequence":"additional","affiliation":[{"name":"Melbourne EpiCentre Royal Melbourne Hospital Melbourne"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Prideaux","sequence":"additional","affiliation":[{"name":"St Vincent's Hospital and University of Melbourne Melbourne Vic."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I. C.","family":"Lawrance","sequence":"additional","affiliation":[{"name":"University of Western Australia Fremantle"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. M.","family":"Andrews","sequence":"additional","affiliation":[{"name":"Royal Adelaide Hospital Adelaide"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P. A.","family":"Bampton","sequence":"additional","affiliation":[{"name":"Flinders Medical Centre and Flinders University Bedford Park SA Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Jakobovits","sequence":"additional","affiliation":[{"name":"Alfred Health and Monash University Melbourne Vic. Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T. H.","family":"Florin","sequence":"additional","affiliation":[{"name":"University of Queensland St Lucia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P. R.","family":"Gibson","sequence":"additional","affiliation":[{"name":"Alfred Health and Monash University Melbourne Vic. Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.","family":"Debinski","sequence":"additional","affiliation":[{"name":"Cabrini Hospital Melbourne"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. B.","family":"Gearry","sequence":"additional","affiliation":[{"name":"Christchurch Hospital Christchurch New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F. A.","family":"Macrae","sequence":"additional","affiliation":[{"name":"Colorectal Medicine and Genetics Royal Melbourne Hospital Melbourne"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. W.","family":"Leong","sequence":"additional","affiliation":[{"name":"Gastroenterology and Liver Services Concord Hospital Sydney"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I.","family":"Kronborg","sequence":"additional","affiliation":[{"name":"Western Hospital Melbourne"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"Radford\u2010Smith","sequence":"additional","affiliation":[{"name":"Queensland Institute of Medical Research and University of Queensland School of Medicine Herston Campus Brisbane"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W.","family":"Selby","sequence":"additional","affiliation":[{"name":"Royal Prince Alfred Hospital Sydney"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. J.","family":"Johnston","sequence":"additional","affiliation":[{"name":"St Vincent's Hospital Melbourne"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Woods","sequence":"additional","affiliation":[{"name":"St Vincent's Hospital Melbourne"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P. R.","family":"Elliott","sequence":"additional","affiliation":[{"name":"St Vincent's Hospital Melbourne"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. J.","family":"Bell","sequence":"additional","affiliation":[{"name":"St Vincent's Hospital and University of Melbourne Melbourne Vic."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. J.","family":"Brown","sequence":"additional","affiliation":[{"name":"St Vincent's Hospital Melbourne"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W. R.","family":"Connell","sequence":"additional","affiliation":[{"name":"St Vincent's Hospital Melbourne"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P. V.","family":"Desmond","sequence":"additional","affiliation":[{"name":"St Vincent's Hospital Melbourne"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,8,28]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"crossref","first-page":"1178","DOI":"10.1136\/gut.2010.234617","article-title":"Surgery for adult Crohn's disease: what is the actual risk?","volume":"60","author":"Bouguen G","journal-title":"Gut"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/0016-5085(90)90613-6"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.33.3.331"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2012.05002.x"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-200001000-00006"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.26.2.146"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/DCR.0b013e3181a4fa58"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2007.01548.x"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00384-008-0542-9"},{"key":"e_1_2_7_11_1","doi-asserted-by":"crossref","first-page":"1406","DOI":"10.1016\/S0140-6736(14)61908-5","article-title":"Crohn's disease management after intestinal resection: a randomised trial","volume":"385","author":"De Cruz P","year":"2014","journal-title":"Lancet"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0016-5085(99)70005-3"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0016-5085(97)70027-1"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2007.05.051"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2008.155812"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)61908-5"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1053\/gast.1997.v113.pm9352848"},{"key":"e_1_2_7_18_1","first-page":"A","article-title":"Meta\u2010analysis of mesalamine in the prevention of postoperative recurrence of Crohn's disease","volume":"136","author":"Doherty GA","year":"2009","journal-title":"Gastroenterology"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/0016-5085(95)90121-3"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2005.01.010"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2008.07.010"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2008.10.051"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2012.218"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/00054725-201112002-00068"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0016-5085(12)60462-4"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2013.287"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.crohns.2013.04.020"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00595-013-0538-0"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.30.7.983"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0016-5107(04)01878-4"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/0016-5085(94)90697-1"},{"key":"e_1_2_7_32_1","doi-asserted-by":"publisher","DOI":"10.1002\/ibd.20872"},{"key":"e_1_2_7_33_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.1800581006"},{"key":"e_1_2_7_34_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-199603000-00005"},{"key":"e_1_2_7_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/0016-5085(83)90444-4"},{"key":"e_1_2_7_36_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.8.4.332"},{"key":"e_1_2_7_37_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.12.7.519"},{"key":"e_1_2_7_38_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0904492"},{"key":"e_1_2_7_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/0016-5085(92)91725-J"},{"key":"e_1_2_7_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/0016-5085(90)90002-I"},{"key":"e_1_2_7_41_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.35.2.231"},{"key":"e_1_2_7_42_1","first-page":"274","article-title":"\u201cCrohn's disease activity index\u201d is inaccurate to detect the post\u2010operative recurrence in Crohn's disease. A GISC study. Gruppo Italiano per lo Studio del Colon e del Retto","volume":"31","author":"Viscido A","year":"1999","journal-title":"Ital J Gastroenterol Hepatol"},{"key":"e_1_2_7_43_1","doi-asserted-by":"publisher","DOI":"10.1053\/gast.2002.31072"},{"key":"e_1_2_7_44_1","doi-asserted-by":"publisher","DOI":"10.1097\/00054725-200207000-00002"},{"key":"e_1_2_7_45_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.25.6.665"},{"key":"e_1_2_7_46_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0016-5085(10)60341-1"},{"key":"e_1_2_7_47_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2011.04710.x"},{"key":"e_1_2_7_48_1","doi-asserted-by":"publisher","DOI":"10.1002\/ibd.22977"},{"issue":"938","key":"e_1_2_7_49_1","first-page":"e1","article-title":"Measurement of Fecal Calprotectin Improves Monitoring and Detection of Recurrence of Crohn's Disease After Surgery","volume":"148","author":"Wright EK","year":"2015","journal-title":"Gastroenterology"},{"key":"e_1_2_7_50_1","doi-asserted-by":"publisher","DOI":"10.1002\/ibd.21825"},{"key":"e_1_2_7_51_1","doi-asserted-by":"crossref","first-page":"617","DOI":"10.1038\/ajg.2011.71","article-title":"Efficacy of 5\u2010aminosalicylates in Crohn's disease: systematic review and meta\u2010analysis","volume":"106","author":"Ford AC","journal-title":"Am J Gastroenterol"},{"key":"e_1_2_7_52_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2010.04231.x"}],"container-title":["Alimentary Pharmacology &amp; Therapeutics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fapt.13353","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fapt.13353","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/apt.13353","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,11]],"date-time":"2023-09-11T10:59:55Z","timestamp":1694429995000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/apt.13353"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,8,28]]},"references-count":51,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2015,10]]}},"alternative-id":["10.1111\/apt.13353"],"URL":"https:\/\/doi.org\/10.1111\/apt.13353","archive":["Portico"],"relation":{},"ISSN":["0269-2813","1365-2036"],"issn-type":[{"value":"0269-2813","type":"print"},{"value":"1365-2036","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,8,28]]}}}