Preventing postoperative Crohn's disease with anti-TNFs: Almost there

Crohn’s disease patients often suffer recurrence after surgery in a relatively short time. Hence, prevention of such complication is an important management consideration. Conventional medical therapies such as antibiotics, mesalamine, and thiopurines have shown little if any benefit for this indication. Recent promising data have shown that postoperative recurrence can be prevented in between 90 and 100% of patients when anti-TNFs are given immediately after surgery. Ongoing randomized clinical trials are now seeking to confirm these findings on a larger scale. This review will focus on the published studies that have used anti-TNFs to prevent postoperative recurrence, outline possible long-term strategies for these patients and review the potential implications of these data.