Meta-analysis: preoperative infliximab treatment and short-term postoperative complications in patients with ulcerative colitis. Yang Z, Wu Q, Wu K, Fan D. Aliment Pharmacol Ther. 2009 Nov 19. [Epub ahead of print] Background: Infliximab was approved for use in ulcerative colitis (UC) in recent years. It has been debated if infliximab increases the risk of postoperative complications in patients with UC. Aim: To perform a meta-analysis that examined the relationship between preoperative infliximab treatment and short-term postoperative complications in patients with UC. Methods: We searched the PubMed and MEDLINE databases to identify observational studies regarding the impact of preoperative infliximab use on short-term postoperative complications in UC. Infectious complications mainly included wound infection, sepsis and abscess, while non-infectious complications included intestinal obstruction, thromboembolism and gastrointestinal haemorrhage etc. Pooled odds ratios (OR) were calculated for each relationship. Results: A total of 5 studies and 706 patients were included in our meta-analysis. Overall, we did not find a strong association between preoperative treatment of infliximab and short-term infectious (OR 2.24, 95% confidence interval [CI] 0.63-7.95) or non-infectious (OR 0.85, 95% CI 0.50-1.45) postoperative complications in UC patients. Whereas we discovered preoperative infliximab use increased short-term total postoperative complications (OR 1.80, 95% CI 1.12-2.87). Conclusions: Preoperative infliximab use increased the risk of short-term postoperative complications. Subgroup analysis is underpowered to assess the nature of these complications but shows a trend towards increased postoperative infection.
Categoria: IBD