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P314. Efficacy and safety of T2 for the prevention of postoperative Crohn's disease

Y. Xie, W. Zhu

Research institute of general surgery,Jinling hospital, Nanjing, China

Aim: Postoperative immunosuppressive therapy is considered as an essential therapy for preventing the recurrence of Crohn's disease. The objective of this study was to evaluate the impact of T2 treatment on clinical and surgical recurrence in patients after intestinal resection for CD.

Materials and Methods: Forty-six patients who were diagnosed as CD and had intestinal operation are reviewed retrospectively. They all had postoperative treatment with T2 (60 mg/day), T2 is a chloroform/methanol extract of Tripterygium wilfordii Hook F (TWHF), the traditional Chinese medicine. Patients had clinical assessments every 3 months; colonoscopy at 6, 12 months. The blood sample was collected during visit for testing the serum triptolide concentration. End points were clinical, endoscopic, and surgical recurrence rates during follow up.

Results: One patient withdrew because of intolerance of T2. Clinical recurrence rate (CDAI > 150) at postoperative 3, 6, 12 months was 0/45 (0%), 2/45 (4.4%), 6/45 (13.3%), endoscopic recurrence rate (Rutgeerts score ≥ 2) at postoperative 6, 12 months was 1/27 (3.7%), 5/27 (18.5%).13 patients developed the adverse effects of T2. Surgical recurrence occurred in 8/45 (17.8%) patients after a median time of 43.7 (range 4–111) months. The serum triptolide concentration between remission and relapse patients was different (P = 0.043).

Conclusions: T2, 60 mg daily, was effective at preventing postoperative recurrence of Crohn's disease and should be considered as a maintenance therapy after intestinal resection. A temporary stoma may delay the recurrence.