Clinical study on the role of immunosuppressant agents in prevention of postoperative recurrence of Crohn's disease

Abstract

Objective To investigate the effects of different therapeutic strategies on recurrence of postoperative Crohn's disease (CD) patients. Methods From September 2009 to September 2014, 85 CD patients with intestinal resection were enrolled. The clinical features and maintenance therapeutic medication were retrospectively analyzed. The patients were divided into non-treatment group (induding continuously or cumulatively taking medicine less than three months), 5-aminosalicylic acid (5-ASA) group and immunosuppressant agents group (including azathioprine, methotrexate and thalidomide). Kaplan-Meier method was performed to compare the recurrence rate in postoperative CD with different therapeutic medication and the risk factors of postoperative recurrence were also analyzed. Results Among 85 CD patients, there were 32, 21 and 32 patients in non-treatment group, 5-ASA group and immunosuppressive agents group, respectively. After surgery, the one year accumulated clinical recurrence rate of immunosuppressant agents group was 12.5% (4/32), which was significantly lower than that of non-treatment group (56.3%, 18/32) and 5-ASA group (38.1%, 8/21), and the differences were statistically significant (χ2=12.250, P 0.05). Penetrating lesion was an risk factor of postoperative clinical recurrence in CD patients (χ2=4.963, P=0.026, odds ratio (OR)=2.221, 95%confidence interval (CI) 1.121 to 5.775). Conclusions Immunosuppressive agents rather than 5-ASA have remarkable effects in preventing postoperative clinical recurrence in CD patients. Postoperative clinical recurrence is more likely to happen in patients with penetrating lesions. Key words: Crohn disease; Postoperative recurrence; Immunosuppressive agents; Retrospective studies