Observational studyBMC gastroenterology2026
Vedolizumab for stricturing Crohn's disease of the terminal ileum - an international multicenter cohort study.
Observational study in BMC gastroenterology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Authors and funding
23 authors.
Funding
Abstract
objectiveCrohn's disease (CD) frequently progresses to stricturing complications. Anti-stricture therapies are lacking, and anti-inflammatory therapies are hence the mainstay of medical treatment. However, data on the efficacy of vedolizumab in stricturing CD are not available. We therefore aimed to assess outcomes of vedolizumab in this setting. DESIGN/
methodWe evaluated adult patients who received vedolizumab within 6 months of imaging-confirmed symptomatic ileal stricturing CD (CONSTRICT criteria) in a multicenter observational cohort study. Images were centrally read by an expert radiologist with experience in IBD imaging. Outcomes were rates of intervention (composite endpoint for endoscopic balloon dilation (EBD) or surgery during follow-up), EBD, surgery, obstructive symptoms, and vedolizumab persistence.
resultsForty-four patients were included (61% female, median age 52 years); 64% had an anastomotic stricture; 84% had received prior biologics. Median follow-up was 17 months. Cumulative intervention rates were 23%, 44% and 50% of patients at 12, 24 and 48 months, respectively. 52% of patients reported symptom resolution, of whom 26% subsequently developed symptoms during follow-up. Vedolizumab persistence was 82%, 74% and 59% at 12, 24 and 48 months. Anastomotic stricture was inversely associated with intervention (HR0.21, P = 0.012) and surgery (HR0.11, P = 0.013). Higher obstructive symptom index (HR4.47, P = 0.040) and degree of prestenotic bowel dilatation (HR1.09, P = 0.030) were associated with recurrent obstructive symptoms. Elevated baseline CRP was associated with vedolizumab discontinuation (HR1.96, P = 0.014).
conclusionVedolizumab appears to be a treatment option in CD patients with terminal ileal strictures, especially in patients with anastomotic strictures, without obstructive symptoms or prestenotic bowel dilatation. Validation in prospective controlled studies is needed.
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