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Statement Rationale and Definition

Up to 30% of patients with ulcerative colitis (UC) and 75% with Crohn’s disease (CD) will require surgery at some point during their disease course.1 Current therapies for inflammatory bowel disease (IBD) focus on immunosuppression, and recent studies have shown combination therapy with anti-tumor necrosis factor-α (anti-TNF) agents and thiopurines to be the most effective for both moderately to severely active UC and CD.2 Despite the use of more effective treatments, in the era of biologic therapy the risk of requiring surgery remains high.3 Before their first surgery, up to 50% of patients have been previously exposed to anti-TNF agents.4 There is concern that preoperative treatment with immunosuppressive medications, including anti-TNF agents, increases the risk of potential postoperative infectious complications.1


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