Early Postoperative Anti-TNF Therapy Does Not Increase Complications Following Abdominal Surgery in Crohn’s Disease

  • Christine A. Schad
  • Bryce E. Haac
  • Raymond K. Cross
  • Ali Syed
  • Shumet Lonsako
  • Andrea C. BaffordEmail author
Original Article



The impact of postoperative anti-TNF therapy on infectious complications following Crohn’s disease surgery remains controversial. Use of anti-TNF therapy 2–4 weeks postoperatively appears safe, but safety of use within 2 weeks is unknown.


We sought to evaluate the effect of anti-TNF therapy initiated within 2 weeks of abdominal surgery in patients with Crohn’s disease.


We conducted a retrospective review of adult Crohn’s disease patients undergoing abdominal surgery between 2004 and 2011. Infectious and non-infectious complications were compared between patients exposed to anti-TNF therapy within 2 weeks or between 2 and 4 weeks postoperatively and to those without exposure using chi-squared and regression analysis.


Three hundred thirty-one abdominal surgeries were included; 241 were without anti-TNF exposure, 46 received postoperative anti-TNF within 2 weeks of surgery, and 44 received anti-TNF therapy 2–4 weeks after surgery. Patients who received anti-TNF therapy within 2 weeks of surgery, those initiated between 2 and 4 weeks of surgery, and those who did not receive anti-TNF therapy within 4 weeks of surgery had no significant difference in rates of infectious complications (22%, 32%, 33%, p = 0.332). Rates of non-infectious complications (4%, 9%, 14%, p = 0.143), mortality (0%, 0%, 3%, p = 0.105), hospital readmission (17%, 16%, 15%, p = 0.940), and reoperation (11%, 11%, 16%, p = 0.563) were also similar between groups.


Use of early anti-TNF therapy within 2 weeks or between 2 and 4 weeks following abdominal surgery did not increase risk of postoperative surgical infections in Crohn’s patients.


Crohn’s disease Anti-TNF Postoperative Complications Infection 


Compliance with ethical standards

Conflict of interest

RK Cross has participated in advisory boards and has engaged in consulting with Abbvie, Janssen, Pfizer, and Takeda. RK Cross has research grants with Abbvie. No grant support was used in this project. The other authors have no potential conflicts of interest to disclose.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Christine A. Schad
    • 1
  • Bryce E. Haac
    • 1
  • Raymond K. Cross
    • 2
  • Ali Syed
    • 2
  • Shumet Lonsako
    • 2
  • Andrea C. Bafford
    • 1
    Email author
  1. 1.Department of SurgeryUniversity of Maryland School of MedicineBaltimoreUSA
  2. 2.Division of Gastroenterology, Department of MedicineUniversity of Maryland School of MedicineBaltimoreUSA

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