Vedolizumab and early postoperative complications in nonintestinal surgery: a case-matched analysis.

Abstract:

Background:Vedolizumab (VDZ) is a gut-specific α4-β7 integrin antagonist that has demonstrated efficacy in Crohn's disease (CD) and ulcerative colitis (UC). The safety of VDZ in the perioperative period remains unclear. The aim of this study was to evaluate postoperative complications and perioperative safety in VDZ-treated patients undergoing nonintestinal operations. Methods:A case-matched study was performed at two inflammatory bowel disease (IBD) referral centers. Adult patients with CD and UC who underwent a nonintestinal surgical procedure during treatment with VDZ were included. Patients who had their last VDZ infusion up to 12 weeks before the procedure were considered exposed and were matched in a 1:1 ratio to patients without VDZ therapy, according to type of surgical procedure, age, and sex. The primary outcome was overall risk of early postoperative infectious complications (up to 30 days after surgery), readmissions, reoperations, surgical site infections, and other infections. The VDZ and control groups were subsequently compared using the Pearson χ2 test and Wilcoxon rank sum. Results:We identified 34 patients treated with VDZ who underwent 36 nonintestinal surgical procedures. These patients were matched with 36 control procedures. Postoperative complications were not different between the VDZ-treated and control cohorts for all outcomes analyzed: infectious complications occurred in 14% versus 8% (p = 0.45), superficial surgical site infections 6% versus 0% (p = 0.15), reoperations 6% versus 3% (p = 0.56) and readmissions 11% versus 6% (p = 0.37). Conclusions:VDZ-treated patients with IBD undergoing nonintestinal procedures did not have an increased risk of overall postoperative infections or other complications compared with matched controls.

authors

Kotze PG,Ma C,Mckenna N,Almutairdi A,Kaplan GG,Raffals LE,Loftus EV Jr,Panaccione R,Lightner AL

doi

10.1177/1756284818783614

subject

Has Abstract

pub_date

2018-06-21 00:00:00

pages

1756284818783614

eissn

1756-283X

issn

1756-2848

pii

10.1177_1756284818783614

journal_volume

11

pub_type

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