Table 2.
Clinical Characteristics of Different Detectable Serum anti-TNFα Drug Levels
Low Level (n=6) |
Medium Level (n=17) |
High Level (n= 44) |
p | |
---|---|---|---|---|
Mean Age (years) | 32.2 (19.2) | 40.1 (17.1) | 37.1 (16.3) | 0.60 |
Gender M:F | 3 : 3 | 13 : 4 | 29 : 15 | 0.46 |
Type of IBD | ||||
Crohn’s disease | 3 (50) | 12 (71) | 35 (79) | 0.23 |
Ulcerative colitis | 3 (50) | 5 (29) | 9 (21) | |
Preoperative Steroids | 3 (50) | 12 (70) | 32 (73) | 0.58 |
Preoperative Immunomodulators | ||||
6-mercaptopurine | 5 (83) | 9 (53) | 33 (75) | 0.23 |
Azathioprine | 0 | 1 (6) | 1 (2) | 0.57 |
Methotrexate | 1 (17) | 1 (6) | 7 (16) | 0.53 |
Cyclosporine | 2 (33) | 1 (6) | 3 (7) | 0.12 |
Preoperative anti-TNFα Agent | ||||
Infliximab alone | 5 (83) | 10 (59) | 21 (48) | 0.27 |
Adalimumab alone | 1 (17) | 5 (29) | 3 (7) | 0.06 |
Certolizumab alone | 0 | 1 (6) | 1 (2) | 0.57 |
Multiple | 0 | 1 (6) | 19 (43) | 0.003 |
Mean Preoperative Lab Values | ||||
Hemoglobin (g/dl) | 10.7 (0.97) | 10.9 (1.98) | 12.7 (1.75) | 0.004 |
Serum albumin (g/dl) | 3.6 (0.34) | 3.42 (0.73) | 4.0 (0.62) | 0.03 |
C-reactive protein (mg/dl) | 5.72 (2.03) | 2.94 (4.03) | 1.76 (2.91) | 0.05 |
Indication for Surgery | ||||
Medical intractability | 6 (100) | 15 (88) | 38 (86) | 1.0 |
Abscess at time of surgery | 0 | 1 (6) | 6 (14) | 0.83 |
Dysplasia/cancer | 0 | 1 (6) | 0 | 0.34 |
Surgical Procedures | ||||
Small bowel/ ileocolic resection | 3 (50) | 12 (71) | 30 (68) | 0.62 |
Ileal pouch-anal anastomosis | 2 (33) | 2 (12) | 3 (7) | 0.10 |
Subtotal colectomy and ileostomy | 1 (17) | 4 (24) | 6 (14) | 0.67 |
Low colorectal anastomosis | 0 | 1 (6) | 5 (11) | 1.0 |
Closure of ileostomy/colostomy | 0 | 0 | 0 | - |
Total proctocolectomy/ileostomy | 0 | 0 | 0 | - |
Pelvic Anastomosis Created | 2 (33) | 3 (18) | 8 (18) | 0.71 |
All values in parentheses denote % except age and preoperative lab values (standard deviation)
IBD inflammatory bowel disease