Evaluating the comparative risk of postoperative complications associated with infliximab and vedolizumab for patients with Crohn’s disease

Abstract

Crohn’s disease is an inflammatory bowel disease that affects millions worldwide. Research indicates that people suffering from Crohn’s disease respond well to monoclonal antibody treatment aimed at characteristic immune cell markers. By targeting immune cell markers, the immune system is subsequently suppressed in a way such that an infection can evolve much quicker. Monoclonal antibody treatment has historically shown to result in increased rates of post-surgical infections in those taking it for Crohn’s disease. Many studies have assessed the increased rates of post-surgical infections following monoclonal antibody treatment for those with Crohn’s disease, but few have compared different treatments. A systematic review of a study that assessed the rates of postoperative infections for those with Crohn’s disease taking infliximab was then compared to the findings of another study which assessed the rates of postoperative infections in those with Crohn’s taking vedolizumab. The patients treated with vedolizumab did not have increased risk of overall postoperative infections or other complications compared with other matched controls. However, those who were treated with infliximab had an increased risk of surgical infections when compared to a control group. Monoclonal antibody treatment for Crohn’s diseases is widespread. It is critical that the side effects of these treatments are readily studied and compared to improve patient outcomes. For this review, infliximab seemed to have a statistically significant increased effect on postoperative infections whereas vedolizumab did not. Further studies with greater sample sizes assessing multiple other side effects of monoclonal antibody immunosuppression are needed.