BACKGROUND: Stenosis is the most common complication of Crohn's disease (CD). Long-term outcome of patients receiving tumour necrosis factor (TNF) antagonists for such disease complication is poorly understood. METHODS: 51 CD patients (from July 2006 to November 2015) who had a diagnosis of small bowel or colonic stenosis, diagnosed by colonoscopy and/or MRI enterography, and were treated with TNF antagonists (adalimumab or infliximab) were enrolled. The primary outcome was to assess the rate of success of TNF antagonists on avoiding abdominal surgery for stricturing CD patients. RESULTS: 20 patients (39.2%) underwent surgery during the follow-up period. The overall incidence of abdominal surgery was 1.8 per 100 person-months at risk, while the median time to surgery was 37.9 months. The univariable and multivariable Cox's proportional hazards analysis of baseline parameters indicated that disease location (colonic vs ileal, HR: 28.2, 95% CI: 2.45-324, p=0.007; ileocolonic vs ileal, HR: 3.38, 95% CI: 1.09-10.5, p=0.035), prestenotic dilatation (per 1-mm increase, HR: 1.08, 95% CI: 1.01-1.15, p=0.022) and the existence of non-perianal fistula (HR: 9.77, 95% CI: 2.99-31.9, p<0.001) are independent risk factors for abdominal surgery. CONCLUSIONS: In stricturing CD, anti-TNFs are effective in up to about two-thirds of the patients.
BACKGROUND: Stenosis is the most common complication of Crohn's disease (CD). Long-term outcome of patients receiving tumour necrosis factor (TNF) antagonists for such disease complication is poorly understood. METHODS: 51 CDpatients (from July 2006 to November 2015) who had a diagnosis of small bowel or colonic stenosis, diagnosed by colonoscopy and/or MRI enterography, and were treated with TNF antagonists (adalimumab or infliximab) were enrolled. The primary outcome was to assess the rate of success of TNF antagonists on avoiding abdominal surgery for stricturing CDpatients. RESULTS: 20 patients (39.2%) underwent surgery during the follow-up period. The overall incidence of abdominal surgery was 1.8 per 100 person-months at risk, while the median time to surgery was 37.9 months. The univariable and multivariable Cox's proportional hazards analysis of baseline parameters indicated that disease location (colonic vs ileal, HR: 28.2, 95% CI: 2.45-324, p=0.007; ileocolonic vs ileal, HR: 3.38, 95% CI: 1.09-10.5, p=0.035), prestenotic dilatation (per 1-mm increase, HR: 1.08, 95% CI: 1.01-1.15, p=0.022) and the existence of non-perianal fistula (HR: 9.77, 95% CI: 2.99-31.9, p<0.001) are independent risk factors for abdominal surgery. CONCLUSIONS: In stricturing CD, anti-TNFs are effective in up to about two-thirds of the patients.
Authors: Iago Rodríguez-Lago; Javier Del Hoyo; Alexandre Pérez-Girbés; Alejandro Garrido-Marín; María José Casanova; María Chaparro; Agnès Fernández-Clotet; Jesús Castro-Poceiro; María José García; Sara Sánchez; Rocío Ferreiro-Iglesias; Iria Bastón; Marta Piqueras; Lola Esteba I Bech de Careda; Raquel Mena; Cristina Suárez; Joaquín Poza Cordón; Alicia López-García; Lucía Márquez; Maite Arroyo; Erika Alfambra; Mónica Sierra; Noelia Cano; Pedro Delgado-Guillena; Víctor Morales-Alvarado; Juan Carlos Aparicio; Iván Guerra; Carolina Aulló; Olga Merino; Laura Arranz; María Araceli Hidalgo; Jordina Llaó; Rocío Plaza; Gema Molina; Paola Torres; Pablo Pérez-Galindo; María Giselle Romero; Claudia Herrera-deGuise; Edisa Armesto; Francisco Mesonero; Santiago Frago-Larramona; José Manuel Benítez; Marta Calvo; María Del Carmen López Martín; Ainara Elorza; Alejandro Larena; Elena Peña; María Del Carmen Rodríguez-Grau; Jaime de Miguel-Criado; Belén Botella; José Antonio Olmos; Laura López; Urko Aguirre; Javier P Gisbert Journal: United European Gastroenterol J Date: 2020-07-28 Impact factor: 4.623
Authors: Fotios S Fousekis; Ioannis V Mitselos; Kostas Tepelenis; George Pappas-Gogos; Konstantinos H Katsanos; Georgios D Lianos; Francesco Frattini; Konstantinos Vlachos; Dimitrios K Christodoulou Journal: J Clin Med Date: 2022-04-23 Impact factor: 4.964
Authors: Sara El Ouali; Benjamin Click; Stefan D Holubar; Florian Rieder Journal: United European Gastroenterol J Date: 2020-01-14 Impact factor: 4.623
Authors: Joseph Sleiman; Sara El Ouali; Taha Qazi; Benjamin Cohen; Scott R Steele; Mark E Baker; Florian Rieder Journal: Expert Rev Gastroenterol Hepatol Date: 2020-12-28 Impact factor: 3.869