RT Journal Article
T1 Early treatment with anti-tumor necrosis factor agents improves long-term effectiveness in symptomatic stricturing Crohn's disease.
A1 Rodriguez-Lago, Iago
A1 Hoyo, Javier Del
A1 Perez-Girbes, Alexandre
A1 Garrido-Marin, Alejandro
A1 Casanova, Maria Jose
A1 Chaparro, María
A1 Fernandez-Clotet, Agnes
A1 Castro-Poceiro, Jesus
A1 García, Maria Jose
A1 Sanchez, Sara
A1 Ferreiro-Iglesias, Rocio
A1 Baston, Iria
A1 Piqueras, Marta
A1 Careda, Lola Esteba I Bech de
A1 Mena, Raquel
A1 Suarez, Cristina
A1 Cordon, Joaquin Poza
A1 Lopez-Garcia, Alicia
A1 Marquez, Lucia
A1 Arroyo, Maite
A1 Alfambra, Erika
A1 Sierra, Monica
A1 Cano, Noelia
A1 Delgado-Guillena, Pedro
A1 Morales-Alvarado, Victor
A1 Aparicio, Juan Carlos
A1 Guerra, Ivan
A1 Aullo, Carolina
A1 Merino, Olga
A1 Arranz, Laura
A1 Hidalgo, Maria Araceli
A1 Llao, Jordina
A1 Plaza, Rocio
A1 Molina, Gema
A1 Torres, Paola
A1 Perez-Galindo, Pablo
A1 Romero, Maria Giselle
A1 Herrera-deGuise, Claudia
A1 Armesto, Edisa
A1 Mesonero, Francisco
A1 Frago-Larramona, Santiago
A1 Benitez, Jose Manuel
A1 Calvo, Marta
A1 Martin, Maria Del Carmen Lopez
A1 Elorza, Ainara
A1 Larena, Alejandro
A1 Peña, Elena
A1 Rodriguez-Grau, Maria Del Carmen
A1 Miguel-Criado, Jaime de
A1 Botella, Belen
A1 Olmos, Jose Antonio
A1 Lopez, Laura
A1 Aguirre, Urko
A1 Gisbert, Javier P
K1 Anti-TNF
K1 Crohn’s disease
K1 biologic drug
K1 stricture
K1 surgery
AB There is limited evidence on the effectiveness of biological therapy in stricturing complications in patients with Crohn's disease. The study aims to determine the effectiveness of anti-tumor necrosis factor (TNF) agents in Crohn's disease complicated with symptomatic strictures. In this multicentric and retrospective study, we included adult patients with symptomatic stricturing Crohn's disease receiving their first anti-TNF therapy, with no previous history of biological, endoscopic or surgical therapy. The effectiveness of the anti-TNF agent was defined as a composite outcome combining steroid-free drug persistence with no use of new biologics or immunomodulators, hospital admission, surgery or endoscopic therapy during follow-up. Overall, 262 patients with Crohn's disease were included (53% male; median disease duration, 35 months, 15% active smokers), who received either infliximab (N = 141, 54%) or adalimumab (N = 121, 46%). The treatment was effective in 87% and 73% of patients after 6 and 12 months, respectively, and continued to be effective in 26% after a median follow-up of 40 months (IQR, 19-85). Nonetheless, 15% and 21% of individuals required surgery after 1 and 2 years, respectively, with an overall surgery rate of 32%. Postoperative complications were identified in 15% of patients, with surgical site infection as the most common. Starting anti-TNF therapy in the first 18 months after the diagnosis of Crohn's disease or the identification of stricturing complications was associated with a higher effectiveness (HR 1.62, 95% CI 1.18-2.22; and HR 1.55, 95% CI 1.1-2.23; respectively). Younger age, lower albumin levels, strictures located in the descending colon, concomitant aminosalicylates use or presence of lymphadenopathy were associated with lower effectiveness. Anti-TNF agents are effective in approximately a quarter of patients with Crohn's disease and symptomatic intestinal strictures, and 68% of patients are free of surgery after a median of 40 months of follow-up. Early treatment and some potential predictors of response were associated with treatment success in this setting.
PB John Wiley & Sons
YR 2020
FD 2020-07-28
LK http://hdl.handle.net/10668/16018
UL http://hdl.handle.net/10668/16018
LA en
NO Rodríguez-Lago I, Hoyo JD, Pérez-Girbés A, Garrido-Marín A, Casanova MJ, Chaparro M, et al. Early treatment with anti-tumor necrosis factor agents improves long-term effectiveness in symptomatic stricturing Crohn's disease. United European Gastroenterol J. 2020 Nov;8(9):1056-1066
DS RISalud
RD Apr 8, 2025