Evidence map›Paper›PMID 40339148›Full record

Trial reportInflammatory bowel diseases2025

Crohn's Disease Stricture Response to Treatment Assessed with Magnetic Resonance Imaging and Intestinal Ultrasound: STRIDENT Randomized Trial.

Grace C Lovett, Julien D Schulberg, Amy L Hamilton, Emily K Wright, Tom R Sutherland, Alyson L Ross, Michael A Kamm

Registry-linked trialAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Inflammatory bowel diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03220841 (Stricture Definition and Treatment), which is not on this map. Cited by 6 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 3 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03220841 phase4unknown statusnot on this map

Stricture Definition and Treatment (STRIDENT) Drug Therapy Study

TypeinterventionalSponsorSt Vincent's Hospital MelbourneRan2017 to 2021Enrolled78ConditionsCrohn Disease, Inflammatory Bowel Diseases, Stricture, BowelArmsAdalimumab Injection, Thiopurine, Endoscopic balloon dilatation
3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Article
  5. Article
  6. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors.

Grace C LovettDepartment of Gastroenterology, St. Vincent's Hospital Melbourne, Melbourne, Australia.ORCID 0000-0003-4662-0021
Julien D SchulbergDepartment of Gastroenterology, St. Vincent's Hospital Melbourne, Melbourne, Australia.ORCID 0000-0002-0257-6535
Amy L HamiltonDepartment of Gastroenterology, St. Vincent's Hospital Melbourne, Melbourne, Australia.ORCID 0000-0002-1627-2057
Emily K WrightDepartment of Gastroenterology, St. Vincent's Hospital Melbourne, Melbourne, Australia.ORCID 0000-0003-3896-7826
Tom R SutherlandDepartment of Radiology, St Vincent's Hospital Melbourne, Melbourne, Australia.ORCID 0000-0001-9668-1995
Alyson L RossDepartment of Gastroenterology, St. Vincent's Hospital Melbourne, Melbourne, Australia.
Michael A KammDepartment of Gastroenterology, St. Vincent's Hospital Melbourne, Melbourne, Australia.ORCID 0000-0003-3319-7199

Funding

AbbVieAustralasian Gastrointestinal Research FoundationGastroenterological Society of Australia IBD Clinician EstablishmentNational Health and Medical Research CouncilSpotlight Foundation
6 · The paper itself

Abstract

backgroundTransmural healing is emerging as a key treatment target in Crohn's disease. This study aimed to determine the role of magnetic resonance imaging (MRI) and intestinal ultrasound (IUS) in the assessment of the radiologic response of Crohn's disease strictures to treatment.

methodsThe STRIDENT (Stricture Definition and Treatment) study was a randomized controlled trial of (2:1) intensive high-dose adalimumab combined with a thiopurine vs standard dose monotherapy adalimumab in patients with stricturing Crohn's disease. Clinical response was defined as a reduction in the Obstructive Symptom Score at 12 months. Intestinal ultrasound was performed at baseline, 4, 8, and 12 months and MRI at baseline and 12 months. This study examines secondary outcomes of stricture resolution and changes in stricture morphology with treatment.

resultsOf 77 patients, 52 were in the intensive treatment group and 25 in the standard therapy group. Clinical response was achieved in 56 of 77 patients (73%). Complete stricture resolution occurred in 17 patients on IUS (29%) and 16 patients on MRI (22%). Stricture improvement occurred in 23 of 59 patients on IUS (39%) and 24 of 72 patients on MRI (33%). Bowel wall thickness improved at 12 months on both IUS (P < .0001) and MRI (P < .001) and was significantly lower in clinical responders (IUS P = .003) and those with fecal calprotectin < 100 µg/g (IUS P < .001; MRI P = .001).

conclusionsRadiologic severity of Crohn's disease strictures can improve with drug treatment, with complete stricture resolution observed in some. Intestinal ultrasound and MRI are effective modalities for monitoring the treatment response in patients with stricturing Crohn's disease (STRIDENT Drug Therapy Study: NCT03220841).

Indexed as

AdalimumabCrohn DiseaseIntestinal ObstructionIntestinesMagnetic Resonance ImagingAdultAzathioprineConstriction, PathologicDrug Therapy, CombinationFemaleHumansMaleMiddle AgedTreatment OutcomeUltrasonographyYoung AdultAdalimumabAzathioprinebowel wall thicknessstricturing Crohn’s diseasetransmural healing

Identifiers

PMID40339148
PMCPMC12558584

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.