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Anti Tumor Necrosis Factor Alpha Agents and Surgical Stress Response

E

El-Hussuna, Alaa, M.D.

Status

Completed

Conditions

Inflammatory Bowel Diseases

Treatments

Drug: Anti-tumor necrosis factor alpha agents

Study type

Observational

Identifiers

Details and patient eligibility

About

Background: The immunologic response to stress is regulated by the cytokines. Anti-Tumor Necrosis Factor-α agents are antibodies directed against a key cytokine in the process angiogenesis and collagen synthesis. It is not known whether they intervene with surgical stress response increasing the rate of postoperative complications.

Method: Un-blinded prospective, non-interventional cohort single centre study including all the patients with Crohn's disease and Ulcerative Colitis undergoing abdominal surgery. Immunological and endocrinological parameters will measured in blood samples taken from these patients before and after surgery. Power calculations showed that 17 patients in each arm are needed.

Full description

The baseline patient characteristics will be evaluated based on pilot tested data extraction sheets. The assessment will include demographics, clinical data as well as laboratory work up. The Charlson morbidity index, will be used to assess co-morbidity, the Nutritional risk score (NRS) to assess nutrition status and the Harvey-Bradshaw index (HBI) to evaluate the activity of Crohn's disease. The duration of surgical procedure, along with the amount of blood transfused, will be recorded in all patients.

Laboratory variables

The following variables will be assessed based on previous evidence about their role in surgical stress response:

  1. Immunological parameters: Tumor necrosis factor-alpha, interleukin-1, interleukin-6, interleukin-10, C reactive protein, and white blood cell counts.
  2. Endocrinological parameters: plasma cortisol, growth hormone , adrenocorticotropic hormone, epinephrin and norepinephrine

Enrollment

47 patients

Sex

All

Volunteers

No Healthy Volunteers

Inclusion criteria

Patients with Crohn disease, ulcerative colitis and indeterminate colitis undergoing elective abdominal surgery (laparoscopic or open)

Exclusion criteria

No patients will be excluded

Trial design

47 participants in 2 patient groups

Inflammatory bowel diseases-1
Description:
Treatment with anti-tumor necrosis factor alpha agents
Treatment:
Drug: Anti-tumor necrosis factor alpha agents
Inflammatory bowel diseases-2
Description:
Controls

Trial contacts and locations

4

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Data sourced from clinicaltrials.gov

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