Anti–Tumor Necrosis Factor-α Antibody Therapy Management Before and After Intestinal Surgery for Inflammatory Bowel Disease: A CCFA Position Paper. Issue 11 (November 2015)

• Record Type: Journal Article
• Authors: Holubar, Stefan D.; Holder-Murray, Jennifer; Flasar, Mark; Lazarev, Mark
• Is Part Of: Inflammatory bowel diseases. Volume 21:Issue 11(2015:Nov.)
• Publication Date: 2015-11
• Subjects: inflammatory bowel disease -- Crohn's disease -- ulcerative colitis -- surgery -- colectomy -- proctectomy -- complications -- biologic therapy -- infliximab -- ileal pouch–anal anastomosis -- anti–TNF-α antibody; Inflammatory bowel diseases -- Periodicals; Colitis, Ulcerative -- Periodicals; Crohn Disease -- Periodicals; Inflammatory Bowel Diseases -- Periodicals; 616.344
• DOI: 10.1097/MIB.0000000000000603
• Languages: English
• ISSNs: 1078-0998

Abstract

Abstract : Abstract: Biologic therapy with anti–tumor necrosis factor (TNF)-α antibody medications has become part of the standard of care for medical therapy for patients with inflammatory bowel disease and may help to avoid surgery in some. However, many of these patients will still require surgical intervention in the form of bowel resection and anastomosis or ostomy formation for the treatment of their disease. Postsurgical studies suggest up to 30% of patients with inflammatory bowel disease may be on or have used anti–TNF-α antibody medications for disease management preoperatively. Significant controversy exists regarding the potential deleterious impact of these medications on the outcomes of surgery, specifically overall and/or infectious complications. In this position statement, we systematically reviewed the literature regarding the potential risk of anti–TNF-α antibody use in the perioperative period, offer recommendations based both on the best-available evidence and expert opinion on the use and timing of anti–TNF-α antibody therapy in the perioperative period, and discuss whether or not the presence of these medications should lead to an alteration in surgical technique such as temporary stoma formation. Abstract : Article first published online 29 September 2015.Supplemental Digital Content is Available in the Text.