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Efficacy of biological agents in stricturing Crohn’s disease: A retrospective cohort study
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| Author:
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MAHMOUD ALCHLAIHAWI, SRIHARAN SELVARATNAM, SUDARSHAN PARAMSOTHY, RUPERT LEONG
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| Abstract:
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Background: Despite the effectiveness of Endoscopic balloon dilatation (EBD) in treating intestinal stricture in Crohn’s disease, there is still a high recurrence rate which leads to high rates of re-dilatation and sometimes leads to failure of the procedure. Aims: The aim is to determine whether biological agents affect the efficacy, safety and longevity following Crohn’s disease intestinal stricture dilatation. Materials and Methods: A retrospective single-center analysis was performed of all patients who underwent EBD between 2010 and 2018 for the management of intestinal strictures due to CD. Patients were analyzed according to whether they received concurrent treatment with biological agents at the time of EBD or not. Short-term efficacy was defined by the initial technical success rate, whilst long-term efficacy was defined by cumulative surgery-free and re-dilatation-free survival rates. Results: Twenty-eight consecutive subjects were recruited comprising of 13 with anastomotic stricture (AS, 13 strictures) and 15 with primary stricture (PS, 21 strictures). There was no difference between the AS and PS cohorts in patients’ demographics and disease characteristics apart from non-statistically significant difference in the presence of fistulas and need for surgery. EBD initial technical success rate was significantly higher for PS (98%) versus AS (70%, p = 0.037). The use of biological agents did not influence either the re-dilatation or surgery-free survival in either AS (HR: 2.07, 95%CI: 0.41–10.36, p = 0.38) or PS (HR: 0.55, 95%CI: 0.11–2.68, p = 0.46) cohorts. Conclusions: EBD is effective and safe. Biological agents did not improve re-dilatation and surgery free survival.
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| Keyword:
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Crohn’s disease; intestinal stricture; biological agents; endoscopic balloon dilatation; complications
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| EOI:
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| DOI:
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https://doi.org/10.31838/ijpr/2020.12.04.629
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| Download:
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