Guasch, MontserratCañete, FiorellaOrdas, IngridIglesias-Flores, EvaClos, AriadnaGisbert, Javier PTaxonera, CarlosVera, IsabelMinguez, MiguelGuardiola, JordiRivero, MontserratNos, PilarGomollon, FernandoBarrio, Jesusde Francisco, RuthLopez-Sanroman, AntonioMartin-Arranz, M DoloresGarcia-Planella, EstherCamargo, RaquelGarcia-Lopez, Santiagode Castro, LuisaCalvet, XavierEsteve, MariaMañosa, MíriamDomenech, Eugeni2023-02-082023-02-082020-12-07Guasch M, Cañete F, Ordás I, Iglesias-Flores E, Clos A, Gisbert JP, et al. Changes in the requirement for early surgery in inflammatory bowel disease in the era of biological agents. J Gastroenterol Hepatol. 2020 Dec;35(12):2080-2087http://hdl.handle.net/10668/15469Biological 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.enAnti-TNFImmunosuppressantsInflammatory bowel diseaseSurgeryAdultAge FactorsBiological FactorsColitis, UlcerativeCrohn DiseaseDisease-Free SurvivalFemaleGastrointestinal AgentsHumansImmunosuppressive AgentsInfliximabMaleMiddle AgedRetrospective StudiesRisk FactorsTime FactorsTumor Necrosis Factor-alphaYoung Adultresearch article32350906Restricted AccessTerapia biológicaAgentes anti‑TNFEnfermedad de CrohnColitis ulcerosaEnfermedades inflamatorias del intestinoAgentes inmunosupresores10.1111/jgh.150841440-1746https://repositorio.uam.es/bitstream/10486/690968/1/changes_guas_JGH_202ps.pdf