Delays in Initiating Post-operative Prophylactic Biologic Therapy Are Common Among Crohn’s Disease Patients

Delays in Initiating Post-operative Prophylactic Biologic Therapy Are Common Among Crohn’s... Background Studies have shown that prophylactic biologic therapy can reduce post-surgical Crohn’s disease recurrence. Aims We aimed to identify the frequency of delay and risk factors associated with a delay in the initiation of prophylactic post-surgical biologic therapy in high-risk patients. Methods We performed a cohort study of Crohn’s disease patients who underwent a bowel resection. We identified those at risk of recurrence and explored multiple characteristics for those with and without a delay post-operatively. Results A total of 84 patients were included in our analysis of which 69.0% had a greater than 4-week delay and 56.0% a greater than 8-week delay in post-surgical biologic prophylaxis. Publicly insured patients had a 100% delay in post-surgical prophylaxis initiation (p = 0.039, p = 0.003 at 4 and 8 weeks, respectively). Patients on a biologic pre-surgery were less likely to have a delay (p < 0.001) in post-operative prophylaxis. Care at an inflammatory bowel disease (IBD) center was associated with timely therapy when considering a post-operative immunomodulator or biologic strategy. Conclusions There are a substantial number of delays in initiating post-operative prophylactic biologic therapy in high-risk patients. Identifying susceptible patients by insurance type or absence of pre-operative therapy can focus future improvement http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Digestive Diseases and Sciences Springer Journals

Delays in Initiating Post-operative Prophylactic Biologic Therapy Are Common Among Crohn’s Disease Patients

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Publisher
Springer US
Copyright
Copyright © 2018 by Springer Science+Business Media, LLC, part of Springer Nature
Subject
Medicine & Public Health; Gastroenterology; Hepatology; Oncology; Transplant Surgery; Biochemistry, general
ISSN
0163-2116
eISSN
1573-2568
D.O.I.
10.1007/s10620-018-5159-4
Publisher site
See Article on Publisher Site

Abstract

Background Studies have shown that prophylactic biologic therapy can reduce post-surgical Crohn’s disease recurrence. Aims We aimed to identify the frequency of delay and risk factors associated with a delay in the initiation of prophylactic post-surgical biologic therapy in high-risk patients. Methods We performed a cohort study of Crohn’s disease patients who underwent a bowel resection. We identified those at risk of recurrence and explored multiple characteristics for those with and without a delay post-operatively. Results A total of 84 patients were included in our analysis of which 69.0% had a greater than 4-week delay and 56.0% a greater than 8-week delay in post-surgical biologic prophylaxis. Publicly insured patients had a 100% delay in post-surgical prophylaxis initiation (p = 0.039, p = 0.003 at 4 and 8 weeks, respectively). Patients on a biologic pre-surgery were less likely to have a delay (p < 0.001) in post-operative prophylaxis. Care at an inflammatory bowel disease (IBD) center was associated with timely therapy when considering a post-operative immunomodulator or biologic strategy. Conclusions There are a substantial number of delays in initiating post-operative prophylactic biologic therapy in high-risk patients. Identifying susceptible patients by insurance type or absence of pre-operative therapy can focus future improvement

Journal

Digestive Diseases and SciencesSpringer Journals

Published: Jun 7, 2018

References

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