Safety and Efficacy of Anti-TNFα Treatment in Crohn's Disease Patients with Abdominal Abscesses

Hepatogastroenterology. 2015 May;62(139):647-52.

Abstract

Background/aims: It is estimated that up to 30% of CD patients develop abdominal abscesses; the management of active luminal CD in such patients represents a clinical challenge. The aim of this study is to assess the safety of biologics in patients with Crohn's disease and abdominal abscesses treated with percutaneous drainage and/or broad-spectrum antibiotics.

Methodology: We performed a retrospective review of the clinical charts of consecutive Crohn's disease patients with abdominal abscesses treated with anti-TNFα therapy attended in our institution.

Results: 12 patients were finally included in the study. All were treated with broad-spectrum antibiotic and biological therapy (anti-TNF); indication of anti-TNFα therapy was moderate to severe activity of CD in all of them. Percutaneous drainage of the abscess was performed in 7 of the 12 patients. No complications were observed during a mean follow-up of 37,8 (16-71) months, including abscess volume increase, enterocutaneous fistula, soft tissue infections, bacteraemia, or need for emergency surgery.

Conclusions: In addition to conventional treatment, the use of anti-TNFα therapy in Crohn's disease patients with abdominal abscesses seems to be safe. Usefulness of this approach has to be validated in larger cohorts.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Abdominal Abscess / diagnosis
  • Abdominal Abscess / immunology
  • Abdominal Abscess / therapy*
  • Adult
  • Anti-Bacterial Agents / adverse effects
  • Anti-Bacterial Agents / therapeutic use*
  • Anti-Inflammatory Agents / adverse effects
  • Anti-Inflammatory Agents / therapeutic use*
  • Biological Products / adverse effects
  • Biological Products / therapeutic use*
  • Crohn Disease / complications
  • Crohn Disease / diagnosis
  • Crohn Disease / drug therapy*
  • Crohn Disease / immunology
  • Drainage* / adverse effects
  • Electronic Health Records
  • Female
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • Risk Factors
  • Severity of Illness Index
  • Time Factors
  • Treatment Outcome
  • Tumor Necrosis Factor-alpha / antagonists & inhibitors*
  • Tumor Necrosis Factor-alpha / immunology
  • Young Adult

Substances

  • Anti-Bacterial Agents
  • Anti-Inflammatory Agents
  • Biological Products
  • Tumor Necrosis Factor-alpha