ArticleDigestive diseases and sciences2017
Medical Therapies for Stricturing Crohn's Disease: Efficacy and Cross-Sectional Imaging Predictors of Therapeutic Failure.
Article in Digestive diseases and sciences, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.
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Who cites it
21 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Systematic review: medical therapy for fibrostenosing Crohn's disease.Alimentary pharmacology & therapeutics · 2020Pooled it
- Vedolizumab for stricturing Crohn's disease of the terminal ileum - an international multicenter cohort study.BMC gastroenterology · 2026Observational
- Predictors of First Anti-TNF Treatment Failure in Patients with Inflammatory Bowel Disease: A Single-Center Cohort Study.Biomedicines · 2026Article
- Colonic strictures in Crohn's disease: a non-surgical survival.Future science OA · 2025Article
- Real-world comparison of effectiveness between ustekinumab and a second-line anti-TNF agent in patients with symptomatic stricturing Crohn's disease failing to respond to a first-line anti-TNF agent: the USTEKNOSIS study.Therapeutic advances in gastroenterology · 2025Article
- Management of Crohn's disease in Taiwan: consensus guideline of the Taiwan Society of Inflammatory Bowel Disease updated in 2023.Intestinal research · 2024Article
- Comprehensive review and update of stricturing Crohn's disease.Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2024Review
- Crohn's disease: an update.Clinical medicine (London, England) · 2023Article
- Predictors and optimal management of tumor necrosis factor antagonist nonresponse in inflammatory bowel disease: A literature review.World journal of gastroenterology · 2023Review
- Validation of stricture length, duration and obstructive symptoms as predictors for intervention in ileal stricturing Crohn's disease.United European gastroenterology journal · 2022Article
- Medical, Endoscopic and Surgical Management of Stricturing Crohn's Disease: Current Clinical Practice.Journal of clinical medicine · 2022Review
- Composite outcomes in observational studies of Crohn's disease: a systematic review and meta-analysis.Therapeutic advances in gastroenterology · 2022Article
- Real world analysis on the efficacy and safety of anti-tumor necrosis factor therapy in patients with stricturing Crohn's disease.Scientific reports · 2021Article
- MR-enterography in Crohn's disease: what MRE mural parameters are associated to one-year therapeutic management outcome?The British journal of radiology · 2021Article
- Crohn's strictures open with anti-mycobacterial antibiotic therapy: A retrospective review.World journal of gastrointestinal endoscopy · 2020Article
- Early treatment with anti-tumor necrosis factor agents improves long-term effectiveness in symptomatic stricturing Crohn's disease.United European gastroenterology journal · 2020Observational
- Fibrostenotic strictures in Crohn's disease.Intestinal research · 2020Review
- The Efficacy of Anti-Tumor Necrosis Factor Alpha for Symptomatic Stricturing Small Bowel Crohn's Disease.Cureus · 2020Article
- The New Proactive Approach and Precision Medicine in Crohn's Disease.Biomedicines · 2020Review
- Strictureplasty in Complex Crohn's Disease: Beyond the Basics.Clinics in colon and rectal surgery · 2019Review
Corrections and comments
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Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMedical therapy efficacy remains controversial in stricturing Crohn's disease. Cross-sectional imaging, especially magnetic resonance imaging, has been suggested as very helpful to guide therapeutic decision making.
aimTo assess efficacy and predictors of therapeutic failure in patients receiving medical treatments for stricturing Crohn's disease.
methodsIn this retrospective study, therapeutic failure was defined as symptomatic stricture leading to surgical or endoscopic therapeutics, hospitalization, treatment discontinuation or additional therapy and short-term clinical response as clinical improvement assessed by two physicians. The 55 cross-sectional imaging examinations (33 magnetic resonance imaging and 22 CT scan) before starting medical therapy were analyzed independently by two radiologists. Results were expressed as hazard ratio (HR) or odds ratio (OR) with 95% confidence intervals (95% CI).
resultsAmong 84 patients, therapeutic failure rate within 60 months was 66.6%. In multivariate analysis, Crohn's disease diagnosis after 40 years old (HR 3.9, 95% CI [1.37-11.2], p = 0.011), small stricture luminal diameter (HR 1.34, 95% CI [1.01-1.80], p = 0.046), increased stricture wall thickness (HR 1.23, 95% CI [1.04-1.46], p = 0.013) and fistula with abscess (HR 5.63, 95% CI [1.64-19.35], p = 0.006) were associated with therapeutic failure, while anti-TNF combotherapy (HR 0.17, 95% CI [0.40-0.71], p = 0.015) prevented it. Considering 108 therapeutic sequences, the short-term clinical response rate was 65.7%. In multivariate analysis, male gender (OR 0.15, 95% CI [0.03-0.64], p = 0.011), fistula with abscess (OR 0.09, 95% CI [0.01-0.77], p = 0.028) and comb sign (OR 0.23, 95% CI [0.005-0.97], p = 0.047) were associated with short-term clinical failure.
conclusionAnti-TNF combotherapy seemed to prevent therapeutic failure, and cross-sectional imaging should be systematically performed to help medical management in stricturing Crohn's disease.
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