Comparative risk of postoperative complications in ulcerative colitis patients following preoperative advanced therapies: a network meta-analysis with meta-regression.

What To Know

A network meta-analysis of 16 retrospective cohort studies (3,235 adults with ulcerative colitis) compared short-term postoperative complication rates after colorectal surgery for patients exposed to biologic or small-molecule therapies within 12 weeks before surgery.

The analysis found that preoperative ustekinumab and tofacitinib were associated with lower 30-day overall complication rates than no biologic/small-molecule exposure or anti-TNF therapy; vedolizumab was associated with fewer 30-day complications than anti-TNF therapy.

Anti-TNF therapy was associated with higher 90-day complication rates versus control, but the 90-day result was based on limited data.

The study pooled retrospective cohort data and used network meta-analysis methods; authors note limitations including the retrospective designs and potential confounding, and they call for well-designed prospective studies to confirm these findings.

If you or your clinician are planning colectomy or other colorectal surgery, this analysis suggests that different preoperative advanced therapies may be associated with different short-term postoperative complication rates, but the evidence is not definitive and should be interpreted with caution.

Talk with your surgical and IBD care teams about timing of surgery and medication management; decisions should be individualized and informed by up-to-date evidence and clinician judgment.