{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T05:29:06Z","timestamp":1778131746999,"version":"3.51.4"},"reference-count":29,"publisher":"Korean Association for the Study of Intestinal Diseases","issue":"3","license":[{"start":{"date-parts":[[2021,8,4]],"date-time":"2021-08-04T00:00:00Z","timestamp":1628035200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["irjournal.org"],"crossmark-restriction":true},"short-container-title":["Intest Res"],"published-print":{"date-parts":[[2022,7,30]]},"abstract":"<jats:p>Background\/Aims: We assessed the effectiveness of anti-TNF agents and its associated factors to prevent endoscopic and clinical postoperative recurrence (POR) in Crohn\u2019s disease (CD). Methods: From a prospectively-maintained database, we retrieved 316 CD patients who underwent intestinal resection (2011\u20132017). Endoscopic (Rutgeerts index \u2265 i2 at 6 months) and clinical (recurrence of symptoms leading to hospitalization or therapeutic escalation) POR were assessed. Results: In 117 anti-TNF-na\u00efve patients, anti-TNF therapy was more effective than immunosuppressive agents (odds ratio [OR], 8.8; 95% confidence interval [CI], 1.8\u201343.9; &lt;i&gt;P&lt;\/i&gt;= 0.008) and no medication\/5-aminosalicylates (OR, 5.2; 95% CI, 1.0\u201327.9; &lt;i&gt;P&lt;\/i&gt;= 0.05) to prevent endoscopic POR. In 199 patients exposed to anti-TNF prior to the surgery, combination with anti-TNF and immunosuppressive agents was more effective than anti-TNF monotherapy (OR, 2.32; 95% CI, 1.02\u20135.31; &lt;i&gt;P&lt;\/i&gt;= 0.046) to prevent endoscopic POR. Primary failure to anti-TNF agent prior to surgery was predictive of anti-TNF failure to prevent endoscopic POR (OR, 2.41; 95% CI, 1.10\u20135.32; &lt;i&gt;P&lt;\/i&gt;= 0.03). When endoscopic POR despite anti-TNF prophylactic medication (n = 55), optimizing anti-TNF and adding an immunosuppressive drug was the most effective option to prevent clinical POR (hazard ratio, 7.38; 95% CI, 1.54\u201335.30; &lt;i&gt;P&lt;\/i&gt;= 0.012). Anti-TNF therapy was the best option to prevent clinical POR (hazard ratio, 3.10; 95% CI, 1.09\u20138.83; &lt;i&gt;P&lt;\/i&gt;= 0.034) in patients with endoscopic POR who did not receive any biologic to prevent endoscopic POR (n = 55). Conclusions: Anti-TNF was the most effective medication to prevent endoscopic and clinical POR. Combination with anti-TNF and immunosuppressive agents should be considered in patients previously exposed to anti-TNF.<\/jats:p>","DOI":"10.5217\/ir.2021.00018","type":"journal-article","created":{"date-parts":[[2021,8,2]],"date-time":"2021-08-02T05:30:41Z","timestamp":1627882241000},"page":"303-312","update-policy":"https:\/\/doi.org\/10.5217\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Factors associated with anti-tumor necrosis factor effectiveness to prevent postoperative recurrence in Crohn\u2019s disease"],"prefix":"10.5217","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6347-409X","authenticated-orcid":true,"given":"Anthony","family":"Buisson","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7621-1398","authenticated-orcid":true,"given":"Lisa","family":"Cannon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0209-3998","authenticated-orcid":true,"given":"Konstantin","family":"Umanskiy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3459-1737","authenticated-orcid":true,"given":"Roger D.","family":"Hurst","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1390-8144","authenticated-orcid":true,"given":"Neil 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