Risk of Infections with Anti-TNF Agents in Patients with Crohn’s Disease After Elective Surgery

Excerpt

We read with interest the article by Hanzel et al. [1] conducting a systematic review and meta-analysis to investigate the relationship between preoperative biological therapy and postoperative outcomes in inflammatory bowel disease (IBD) focusing on elective surgery. The author found that anti-tumor necrosis factor (anti-TNF) therapy prior to elective surgery may increase the odds of postoperative infection in Crohn’s disease (CD). We also read two meta-analyses about the risk of postoperative complications following preoperative anti-TNF therapy in patients with CD [2, 3]. The first meta-analysis concluded that preoperative anti-TNF therapy increases the occurrence of overall postoperative complications, and particularly infectious complications. The second meta-analysis concluded that anti-TNF therapy does not increase the risk of postoperative complications. We are confused by these different conclusions, several questions deserve attention. …