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Pre-operative use of anti-TNF-α agents and the risk of post-operative complications in patients with ulcerative colitis - a nationwide cohort study
Alimentary Pharmacology and Therapeutics,  Clinical Article

Norgard BM et al. – Based on nationwide data on ulcerative colitis (UC) patients having colectomies, pre–operative use of anti–TNF–α agents did not increase the risk of post–operative complications.

Methods
  • Based on the Danish National Patient Registry the authors identified all UC patients, aged ≥15 years, having their first surgery for UC in the period of 1 January 2003-31 December 2010 (n = 1226).
  • Patients were classified according to use of anti-TNF-α agents within 12 weeks before surgery or not.
  • Outcome data were obtained from Danish registries.
  • Logistic regression analyses were used to estimate adjusted risks [with 95% confidence intervals (CI)] of post-operative outcomes among patients treated with anti-TNF-α agents, relative to those not treated.

Results
  • A total of 199 UC patients were exposed to anti-TNF-α agents within 12 weeks before colectomy, and 1027 were not.
  • Among exposed, the adjusted odds ratio of reoperation and anastomosis leakage within 30 days after colectomy was 1.07 (95% CI: 0.71-1.59) and 0.52 (95% CI: 0.06-4.11) respectively.
  • No deaths, cases of abscess drainage or bacteremia occurred among exposed within 30 days.
  • Furthermore, no increased relative risks were found within 60 days after colectomy.

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