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Vedolizumab and early postoperative complications in nonintestinal surgery: a case-matched analysis

BACKGROUND: Vedolizumab (VDZ) is a gut-specific α4-β7 integrin antagonist that has demonstrated efficacy in Crohn’s disease (CD) and ulcerative colitis (UC). The safety of VDZ in the perioperative period remains unclear. The aim of this study was to evaluate postoperative complications and periopera...

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Autores principales: Kotze, Paulo Gustavo, Ma, Christopher, Mckenna, Nicholas, Almutairdi, Abdulelah, Kaplan, Gilaad G., Raffals, Laura E., Loftus, Edward V., Panaccione, Remo, Lightner, Amy L.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6024272/
https://www.ncbi.nlm.nih.gov/pubmed/29977340
http://dx.doi.org/10.1177/1756284818783614
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author Kotze, Paulo Gustavo
Ma, Christopher
Mckenna, Nicholas
Almutairdi, Abdulelah
Kaplan, Gilaad G.
Raffals, Laura E.
Loftus, Edward V.
Panaccione, Remo
Lightner, Amy L.
author_facet Kotze, Paulo Gustavo
Ma, Christopher
Mckenna, Nicholas
Almutairdi, Abdulelah
Kaplan, Gilaad G.
Raffals, Laura E.
Loftus, Edward V.
Panaccione, Remo
Lightner, Amy L.
author_sort Kotze, Paulo Gustavo
collection PubMed
description BACKGROUND: Vedolizumab (VDZ) is a gut-specific α4-β7 integrin antagonist that has demonstrated efficacy in Crohn’s disease (CD) and ulcerative colitis (UC). The safety of VDZ in the perioperative period remains unclear. The aim of this study was to evaluate postoperative complications and perioperative safety in VDZ-treated patients undergoing nonintestinal operations. METHODS: A case-matched study was performed at two inflammatory bowel disease (IBD) referral centers. Adult patients with CD and UC who underwent a nonintestinal surgical procedure during treatment with VDZ were included. Patients who had their last VDZ infusion up to 12 weeks before the procedure were considered exposed and were matched in a 1:1 ratio to patients without VDZ therapy, according to type of surgical procedure, age, and sex. The primary outcome was overall risk of early postoperative infectious complications (up to 30 days after surgery), readmissions, reoperations, surgical site infections, and other infections. The VDZ and control groups were subsequently compared using the Pearson χ(2) test and Wilcoxon rank sum. RESULTS: We identified 34 patients treated with VDZ who underwent 36 nonintestinal surgical procedures. These patients were matched with 36 control procedures. Postoperative complications were not different between the VDZ-treated and control cohorts for all outcomes analyzed: infectious complications occurred in 14% versus 8% (p = 0.45), superficial surgical site infections 6% versus 0% (p = 0.15), reoperations 6% versus 3% (p = 0.56) and readmissions 11% versus 6% (p = 0.37). CONCLUSIONS: VDZ-treated patients with IBD undergoing nonintestinal procedures did not have an increased risk of overall postoperative infections or other complications compared with matched controls.
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spelling pubmed-60242722018-07-05 Vedolizumab and early postoperative complications in nonintestinal surgery: a case-matched analysis Kotze, Paulo Gustavo Ma, Christopher Mckenna, Nicholas Almutairdi, Abdulelah Kaplan, Gilaad G. Raffals, Laura E. Loftus, Edward V. Panaccione, Remo Lightner, Amy L. Therap Adv Gastroenterol Original Research BACKGROUND: Vedolizumab (VDZ) is a gut-specific α4-β7 integrin antagonist that has demonstrated efficacy in Crohn’s disease (CD) and ulcerative colitis (UC). The safety of VDZ in the perioperative period remains unclear. The aim of this study was to evaluate postoperative complications and perioperative safety in VDZ-treated patients undergoing nonintestinal operations. METHODS: A case-matched study was performed at two inflammatory bowel disease (IBD) referral centers. Adult patients with CD and UC who underwent a nonintestinal surgical procedure during treatment with VDZ were included. Patients who had their last VDZ infusion up to 12 weeks before the procedure were considered exposed and were matched in a 1:1 ratio to patients without VDZ therapy, according to type of surgical procedure, age, and sex. The primary outcome was overall risk of early postoperative infectious complications (up to 30 days after surgery), readmissions, reoperations, surgical site infections, and other infections. The VDZ and control groups were subsequently compared using the Pearson χ(2) test and Wilcoxon rank sum. RESULTS: We identified 34 patients treated with VDZ who underwent 36 nonintestinal surgical procedures. These patients were matched with 36 control procedures. Postoperative complications were not different between the VDZ-treated and control cohorts for all outcomes analyzed: infectious complications occurred in 14% versus 8% (p = 0.45), superficial surgical site infections 6% versus 0% (p = 0.15), reoperations 6% versus 3% (p = 0.56) and readmissions 11% versus 6% (p = 0.37). CONCLUSIONS: VDZ-treated patients with IBD undergoing nonintestinal procedures did not have an increased risk of overall postoperative infections or other complications compared with matched controls. SAGE Publications 2018-06-21 /pmc/articles/PMC6024272/ /pubmed/29977340 http://dx.doi.org/10.1177/1756284818783614 Text en © The Author(s), 2018 http://www.creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Original Research
Kotze, Paulo Gustavo
Ma, Christopher
Mckenna, Nicholas
Almutairdi, Abdulelah
Kaplan, Gilaad G.
Raffals, Laura E.
Loftus, Edward V.
Panaccione, Remo
Lightner, Amy L.
Vedolizumab and early postoperative complications in nonintestinal surgery: a case-matched analysis
title Vedolizumab and early postoperative complications in nonintestinal surgery: a case-matched analysis
title_full Vedolizumab and early postoperative complications in nonintestinal surgery: a case-matched analysis
title_fullStr Vedolizumab and early postoperative complications in nonintestinal surgery: a case-matched analysis
title_full_unstemmed Vedolizumab and early postoperative complications in nonintestinal surgery: a case-matched analysis
title_short Vedolizumab and early postoperative complications in nonintestinal surgery: a case-matched analysis
title_sort vedolizumab and early postoperative complications in nonintestinal surgery: a case-matched analysis
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6024272/
https://www.ncbi.nlm.nih.gov/pubmed/29977340
http://dx.doi.org/10.1177/1756284818783614
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