But just what length of time actually constitutes “immediately after surgery?” In the PREVENT trial, clinicians had up to 45 days to begin therapy, although Dr. Regueiro said he prefers to start between 2 and 4 weeks postsurgery, a number with which panel moderator Dr. David T. Rubin, codirector of the University of Chicago Digestive Diseases Center, agreed.
While these study results help pinpoint the range for when to use biologics, Dr. Regueiro said in the interview, “Future study is need to determine the ‘tipping point’ where postoperative Crohn’s disease recurrence results in significant bowel damage and renders medications ineffective. Finding the ‘biologic sweet spot’ of when to start aggressive therapy versus a ‘wait and watch’ approach remains the question.”
Dr. Regueiro disclosed he is a consultant for AbbVie, Janssen, UCB, Pfizer, and Takeda.
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