Safety and Efficacy of Infusional Perioperative Tacrolimus Therapy in Crohn’s Disease Patients Undergoing Intestinal Resection

Introduction: Perioperative optimization of Crohn’s disease (CD) patients is mandatory in order to ensure favorable outcomes and limit perioperative morbidity such as anastomosis-related complications. The use of perioperative tacrolimus may offer beneficial inflammatory control and impro...

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Main Authors: Maximilian Beck, Niklas Schomburg, Max Albers, Detlef Bartsch, Niklas Knapp, Jan Granseyer, Thomas Gress, Christian Bauer
Format: Article
Language:English
Published: Karger Publishers 2025-01-01
Series:Inflammatory Intestinal Diseases
Online Access:https://karger.com/article/doi/10.1159/000542443
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author Maximilian Beck
Niklas Schomburg
Max Albers
Detlef Bartsch
Niklas Knapp
Jan Granseyer
Thomas Gress
Christian Bauer
author_facet Maximilian Beck
Niklas Schomburg
Max Albers
Detlef Bartsch
Niklas Knapp
Jan Granseyer
Thomas Gress
Christian Bauer
author_sort Maximilian Beck
collection DOAJ
description Introduction: Perioperative optimization of Crohn’s disease (CD) patients is mandatory in order to ensure favorable outcomes and limit perioperative morbidity such as anastomosis-related complications. The use of perioperative tacrolimus may offer beneficial inflammatory control and improve postoperative outcome. However, it also may exhibit unwanted effects of immunosuppression on infectious complications and wound healing. Methods: This is a single-center, retrospective study of CD patients undergoing intestinal resection between 2009 and 2018. Characteristics of CD patients receiving infusional perioperative tacrolimus or not were systematically evaluated and exploratively compared. To investigate the impact of tacrolimus and other predictors on postoperative infectious complications, simple regression with a threshold of p < 0.05 was used. Significant predictors of the simple regression analysis, as well as tacrolimus, were then included into multiple logistic regression. Results: This analysis included 30 patients (34.88%) having received tacrolimus perioperatively and 56 patients (65.12%) that were not treated with tacrolimus. In median, 1 mg/day of tacrolimus was given intravenously for 11 days. Adverse events occurred in 3 patients (10%). The most common adverse events were headache and paresthesia. Tacrolimus showed no significant correlation to postoperative infectious complications. Furthermore, multiple regression analysis found no significant effect of tacrolimus on postoperative infectious complications when controlling for previously identified confounders. Conclusion: Administration of tacrolimus showed no negative impact on postoperative infectious complications in the study cohort, indicating safety of perioperative tacrolimus therapy. By describing in detail our study population of patients receiving perioperative tacrolimus, we provide data guiding future prospective studies.
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spelling doaj-art-cbafceaac1c64696a9944fff16a345cc2025-08-20T03:09:47ZengKarger PublishersInflammatory Intestinal Diseases2296-93652025-01-01101183310.1159/000542443Safety and Efficacy of Infusional Perioperative Tacrolimus Therapy in Crohn’s Disease Patients Undergoing Intestinal ResectionMaximilian BeckNiklas SchomburgMax AlbersDetlef BartschNiklas KnappJan GranseyerThomas Gresshttps://orcid.org/0000-0002-9333-5461Christian Bauer Introduction: Perioperative optimization of Crohn’s disease (CD) patients is mandatory in order to ensure favorable outcomes and limit perioperative morbidity such as anastomosis-related complications. The use of perioperative tacrolimus may offer beneficial inflammatory control and improve postoperative outcome. However, it also may exhibit unwanted effects of immunosuppression on infectious complications and wound healing. Methods: This is a single-center, retrospective study of CD patients undergoing intestinal resection between 2009 and 2018. Characteristics of CD patients receiving infusional perioperative tacrolimus or not were systematically evaluated and exploratively compared. To investigate the impact of tacrolimus and other predictors on postoperative infectious complications, simple regression with a threshold of p < 0.05 was used. Significant predictors of the simple regression analysis, as well as tacrolimus, were then included into multiple logistic regression. Results: This analysis included 30 patients (34.88%) having received tacrolimus perioperatively and 56 patients (65.12%) that were not treated with tacrolimus. In median, 1 mg/day of tacrolimus was given intravenously for 11 days. Adverse events occurred in 3 patients (10%). The most common adverse events were headache and paresthesia. Tacrolimus showed no significant correlation to postoperative infectious complications. Furthermore, multiple regression analysis found no significant effect of tacrolimus on postoperative infectious complications when controlling for previously identified confounders. Conclusion: Administration of tacrolimus showed no negative impact on postoperative infectious complications in the study cohort, indicating safety of perioperative tacrolimus therapy. By describing in detail our study population of patients receiving perioperative tacrolimus, we provide data guiding future prospective studies. https://karger.com/article/doi/10.1159/000542443
spellingShingle Maximilian Beck
Niklas Schomburg
Max Albers
Detlef Bartsch
Niklas Knapp
Jan Granseyer
Thomas Gress
Christian Bauer
Safety and Efficacy of Infusional Perioperative Tacrolimus Therapy in Crohn’s Disease Patients Undergoing Intestinal Resection
Inflammatory Intestinal Diseases
title Safety and Efficacy of Infusional Perioperative Tacrolimus Therapy in Crohn’s Disease Patients Undergoing Intestinal Resection
title_full Safety and Efficacy of Infusional Perioperative Tacrolimus Therapy in Crohn’s Disease Patients Undergoing Intestinal Resection
title_fullStr Safety and Efficacy of Infusional Perioperative Tacrolimus Therapy in Crohn’s Disease Patients Undergoing Intestinal Resection
title_full_unstemmed Safety and Efficacy of Infusional Perioperative Tacrolimus Therapy in Crohn’s Disease Patients Undergoing Intestinal Resection
title_short Safety and Efficacy of Infusional Perioperative Tacrolimus Therapy in Crohn’s Disease Patients Undergoing Intestinal Resection
title_sort safety and efficacy of infusional perioperative tacrolimus therapy in crohn s disease patients undergoing intestinal resection
url https://karger.com/article/doi/10.1159/000542443
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