3 research outputs found
SAFETY PROFILE OF ANTI-TNF THERAPY IN CROHNâS DISEASE MANAGEMENT: A BRAZILIAN SINGLE-CENTER DIRECT RETROSPECTIVE COMPARISON BETWEEN INFLIXIMAB AND ADALIMUMAB
SAFETY PROFILE OF ANTI-TNF THERAPY IN CROHNâS DISEASE MANAGEMENT: A BRAZILIAN SINGLE-CENTER DIRECT RETROSPECTIVE COMPARISON BETWEEN INFLIXIMAB AND ADALIMUMAB
ABSTRACT BACKGROUND: Infliximab and adalimumab are considered effective drugs in the management of Crohnâs disease. However, due to significant immunossupression, they can cause important adverse events, mostly infections. OBJECTIVE: The aim of this study was to quantify and describe adverse events derived from adalimumab and infliximab use in Crohnâs disease patients, and to compare the safety profile between these two agents. METHODS: This was an observational, single-center, longitudinal, retrospective study with Crohnâs disease patients under infliximab or adalimumab therapy. Variables analyzed: demographic characteristics (including the Montreal classification), type of agent used, concomitant immunomodulators, presence and types of adverse events observed. Patients were allocated in two groups (infliximab and adalimumab) and had their adverse events accessed and subsequently compared. RESULTS: A total of 130 patients were included (68 in infliximab and 62 in adalimumab groups, respectively). The groups were fully homogeneous in all baseline characteristics, with a median follow-up of 47.21±36.52 months in the infliximab group and 47.79±35.09 in the adalimumab group (P=0.512). Adverse events were found in 43/68 (63.2%) and 40/62 (64.5%) in each group, respectively (P=0.879). There were no differences between the groups regarding infections (P=0.094) or treatment interruption (P=0.091). There were higher rates of infusion reactions in the infliximab group (P=0.016). Cephalea and injection site reactions were more prevalent in adalimumab patients. CONCLUSION: Adverse events were found in approximately two thirds of Crohnâs disease patients under anti-TNF therapy, and there were no significant differences between infliximab or adalimumab
Postoperative complication rates between Crohn's disease and Colorectal cancer patients after ileocolic resections: a comparative study
Introduction: Ileocolic resection (ICR) is the most common surgical procedure performed for Crohn's disease (CD). Similarly, right-sided Colorectal cancer (CRC) is treated by the same operation. The primary aim of this study was to analyze and compare the frequency and profile of early postoperative complications of ICR between patients with CD and CRC. Methods: Retrospective and observational study with patients submitted to ICR from two Brazilian tertiary referral units in colorectal surgery. We included patients with diagnosis of CD or CRC, treated with ICR, at any stage of follow-up. Variables analyzed: age at surgery, gender, diagnosis, surgical approach (open or laparoscopy), type of anastomosis (hand-sewn/stapled; end-to-end/side-to-side), presence and type of early postoperative complications (30 days) and mortality, among others. Results: 109 patients were included, 73 with CD (67%) and 36 with CRC (33%). CD patients were younger (42.44 ± 12.73 years vs. 66.14 ± 11.02 years in the CRC groups, p < 0.0001) and had more previous resections (20 ± 27.4 in CD and 0 in CCR, p = 0.001). There were no significant differences between the groups in terms of overall early postoperative complications [17/73 (23.3%) in the CD and 5/36 (13.9%) in the CRC groups (p = 0.250)]. There was no significant difference between the groups in relation to anastomotic leakage (p = 0.185), surgical site infections (p = 0.883), other complications (0.829) and deaths (p = 0.069). Conclusions: There was no significant difference in early postoperative complications in patients with CD or CRC submitted to ICR. Resumo: Introdução: A ileocolectomia direita (ICD) Ă© a operação mais realizada no manejo cirĂșrgico da doença de Crohn (DC). Da mesma forma, Ă© o procedimento de escolha no tratamento do cĂąncer colorretal (CCR) quando localizado Ă direita. O objetivo deste estudo foi analisar e comparar as complicaçÔes cirĂșrgicas em pacientes submetidos a ICD por DC e CCR em uma coorte de pacientes. MĂ©todo: Estudo longitudinal, retrospectivo e observacional, de uma coorte de pacientes submetidos a ICD provenientes de 2 centros de referĂȘncia em coloproctologia. Os critĂ©rios de inclusĂŁo foram pacientes com DC ou CCR, submetidos a ICD, em qualquer estĂĄgio de acompanhamento. As variĂĄveis analisadas foram: idade Ă cirurgia, gĂȘnero, diagnĂłstico, abordagem (aberta ou laparoscĂłpica), tipo de anastomose, presença e tipo de complicaçÔes pĂłs-operatĂłrias precoces (atĂ© 30 dias) e Ăłbito. Resultados: Foram incluidos 109 pacientes, 73 com DC (67%) e 36 com CCR (33%). Os grupos foram homogĂȘneos em todas as variĂĄveis, Ă exceção da idade (42,44 ± 12,73 na DC e 66,14 ± 11,02 no CCR, p < 0,0001). NĂŁo houve diferença entre os grupos em relação Ă s complicaçÔes precoces, com 17/67 (23,3%) na DC e 5/36 (13,9%) no CCR, p = 0,250. Da mesma forma, nĂŁo houve diferença entre os grupos em relação a deiscĂȘncia de anastomose (p = 0,185), infecçÔes do sĂtio cirĂșrgico (p = 0,883), outras complicaçÔes (0,829) e Ăłbitos (p = 0,069). ConclusĂ”es: NĂŁo houve diferença nas complicaçÔes pĂłs-operatĂłrias em pacientes submetidos a ICD entre portadores de DC e CCR. Keywords: Crohn's disease, Colorectal cancer, Complication, Postoperative, Palavras-chave: Doença de Crohn, CĂąncer colorretal, ComplicaçÔes, PĂłs-operatĂłri