%0 Journal Article
%A Guasch, Montserrat
%A Cañete, Fiorella
%A Ordas, Ingrid
%A Iglesias-Flores, Eva
%A Clos, Ariadna
%A Gisbert, Javier P
%A Taxonera, Carlos
%A Vera, Isabel
%A Minguez, Miguel
%A Guardiola, Jordi
%A Rivero, Montserrat
%A Nos, Pilar
%A Gomollon, Fernando
%A Barrio, Jesus
%A de Francisco, Ruth
%A Lopez-Sanroman, Antonio
%A Martin-Arranz, M Dolores
%A Garcia-Planella, Esther
%A Camargo, Raquel
%A Garcia-Lopez, Santiago
%A de Castro, Luisa
%A Calvet, Xavier
%A Esteve, Maria
%A Mañosa, Míriam
%A Domenech, Eugeni
%T Changes in the requirement for early surgery in inflammatory bowel disease in the era of biological agents.
%D 2020
%U http://hdl.handle.net/10668/15469
%X Biological therapies may be changing the natural history of inflammatory bowel diseases (IBDs), reducing the need for surgical intervention. We aimed to assess whether the availability of anti-TNF agents impacts the need for early surgery in Crohn's disease (CD) and ulcerative colitis (UC). Retrospective, cohort study of patients diagnosed within a 6-year period before and after the licensing of anti-TNFs (1990-1995 and 2007-2012 for CD; 1995-2000 and 2007-2012 for UC) were identified in the ENEIDA Registry. Surgery-free survival curves were compared between cohorts. A total of 7370 CD patients (2022 in Cohort 1 and 5348 in Cohort 2) and 8069 UC patients (2938 in Cohort 1 and 5131 in Cohort 2) were included. Immunosuppressants were used significantly earlier and more frequently in both CD and UC post-biological cohorts. The cumulative probability of surgery was lower in CD following anti-TNF approval (16% and 11%, 22% and 16%, and 29% and 19%, at 1, 3, and 5 years, respectively P  Anti-TNF availability was associated with a reduction in early surgery for CD (driven mainly by earlier and more widespread immunosuppressant use) but not in UC.
%K Anti-TNF
%K Immunosuppressants
%K Inflammatory bowel disease
%K Surgery
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