These two authors contributed equally to this work.
Meta-analysis: pre-operative infliximab treatment and short-term post-operative complications in patients with ulcerative colitis
Article first published online: 19 NOV 2009
© 2010 Blackwell Publishing Ltd
Alimentary Pharmacology & Therapeutics
Volume 31, Issue 4, pages 486–492, February 2010
How to Cite
YANG, Z., WU, Q., WU, K. and FAN, D. (2010), Meta-analysis: pre-operative infliximab treatment and short-term post-operative complications in patients with ulcerative colitis. Alimentary Pharmacology & Therapeutics, 31: 486–492. doi: 10.1111/j.1365-2036.2009.04204.x
- Issue published online: 12 JAN 2010
- Article first published online: 19 NOV 2009
- Publication data Submitted 13 October 2009 First decision 6 November 2009 Resubmitted 15 November 2009 Accepted 16 November 2009 Epub Accepted Article 19 November 2009
Aliment Pharmacol Ther 31, 486–492
Background Infliximab was approved for use in ulcerative colitis in recent years. It has been debated if infliximab increases the risk of post-operative complications in patients with ulcerative colitis.
Aim To perform a meta-analysis that examines the relationship between preoperative infliximab treatment and short-term post-operative complications in patients with ulcerative colitis.
Methods We searched the PubMed and MEDLINE databases to identify observational studies on the impact of pre-operative infliximab use on short-term post-operative complications in ulcerative colitis. Infectious complications mainly included wound infection, sepsis and abscess, whereas non-infectious complications included intestinal obstruction, thromboembolism and gastrointestinal haemorrhage. Pooled odds ratios (ORs) 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 pre-operative 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) post-operative complications in ulcerative colitis patients. On the contrary, we discovered that pre-operative infliximab use increased short-term total post-operative complications (OR 1.80, 95% CI 1.12–2.87).
Conclusions Pre-operative infliximab use increased the risk of short-term post-operative complications. Subgroup analysis is underpowered to assess the nature of these complications but shows a trend towards increased post-operative infection.