Rutgeerts i2 after ileocolic resection: anti-TNF or mesalamine
After ileocolic resection in an asymptomatic patient with a Rutgeerts score of i2, is anti‑TNF or continued mesalamine maintenance preferred
a small prospective pilot found that in patients maintained on mesalamine who developed early endoscopic recurrence after ileocolonic resection, switching to infliximab was studied as an escalation strategy. Mesalamine alone was the group that recurred 1. the retrieved evidence does not provide a head-to-head trial establishing that anti-TNF is superior to continued mesalamine for asymptomatic i2 recurrence specifically, so this comparison cannot be settled from these excerpts.
References
- Yamamoto T, Umegae S, Matsumoto K. Impact of infliximab therapy after early endoscopic recurrence following ileocolonic resection of Crohn's disease: a prospective pilot study. Inflamm Bowel Dis. 2009;15(10):1460-6. PMID: 19266566.
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⚠ Required context not in this corpus (moderate). WITHOUT prophylaxis, ANY endoscopic recurrent lesion in the neoterminal ileum is seen in ~73% within 1 year and ~85% by 3 years of ileocolic resection (Rutgeerts 1990, PMID 2394349). The baseline is the majority, not a minority. (Denominator is any lesion, not a >=i2 cut.)
Why this matters: Understating the untreated recurrence rate makes declining postoperative prophylaxis look reasonable when the expected course is recurrence in most patients.
Added by the landmark interlock. This corpus is surgical in scope and cannot admit the source paper (PMID 2394349). Not generated by the RAG.
Draft, generated by the IBDology RAG and not yet clinician-reviewed. Answers are grounded in the retrieved literature listed above; a high faithfulness score means the answer matches its sources, not that the sources are correct.
Reviewer notes