Optimal use of biologics with endoscopic balloon dilatation for repeated intestinal strictures in Crohn's disease

JGH Open : an Open Access Journal of Gastroenterology and Hepatology
Akihito UdaKiyohide Fushimi

Abstract

Intestinal strictures in Crohn's disease (CD) have a high rate of repeated surgery. As alternatives to surgery, endoscopic balloon dilatation (EBD), immunomodulators (IMs), and antitumor necrosis factor alpha (anti-TNFα) have been proposed. We aimed to assess the effectiveness of the combined therapy with anti-TNFα and EBD in preventing intestinal stricture recurrence and surgery in patients with CD. This retrospective cohort study included patients from the nationwide administrative database in Japan who were hospitalized and underwent at least one EBD between 1 April 2010 and 31 March 2017. The effectiveness of anti-TNFα was evaluated by performing survival analysis for the primary outcome. We selected the inverse probability of treatment weighting method for adjustment of covariates. As an exploratory analysis, we evaluated the association of anti-TNFα initiation timing with intestinal stricture recurrence. The anti-TNFα exposed group had a significantly lower risk of intestinal stricture recurrence than that of the anti-TNFα nonexposed group (hazard ratio = 0.38, 95% confidence interval 0.31-0.48, P < 0.001). Surgery-free rate was shown to have the same tendency. Anti-TNFα therapy initiation before or after EBD resulted in ...Continue Reading

References

Sep 1, 1991·Annals of Surgery·F MichelassiG E Block
Mar 1, 1987·Diseases of the Colon and Rectum·P H HarperK A Easley
Jan 15, 2000·Annals of Surgery·O BernellG Hellers
Jun 6, 2002·Lancet·Stephen B HanauerUNKNOWN ACCENT I Study Group
Jul 20, 2002·Inflammatory Bowel Diseases·Jacques CosnesJean-Pierre Gendre
Sep 14, 2004·Gastroenterology·Sandro ArdizzoneGabriele Bianchi Porro
Apr 12, 2006·The American Journal of Gastroenterology·Gary R LichtensteinWilliam J Sandborn
Oct 2, 2007·Alimentary Pharmacology & Therapeutics·C HassanS Morini
May 9, 2009·Journal of Gastroenterology·Keiko AsakuraToru Takebayashi
May 30, 2009·Journal of the American College of Surgeons·Alexander J GreensteinAdrian J Greenstein
Apr 16, 2010·The New England Journal of Medicine·Jean Frédéric ColombelUNKNOWN SONIC Study Group
Oct 20, 2012·Digestive Endoscopy : Official Journal of the Japan Gastroenterological Endoscopy Society·Yoichiro OnoKitaro Futami
Feb 1, 2013·Digestive Endoscopy : Official Journal of the Japan Gastroenterological Endoscopy Society·Yusuke HonzawaTsutomu Chiba
Jun 4, 2015·The Cochrane Database of Systematic Reviews·Ali RezaieCynthia H Seow
Apr 15, 2016·World Journal of Gastroenterology : WJG·Emily K WrightDanny Liew
Oct 30, 2016·Journal of Crohn's & Colitis·Takayuki MatsumotoUNKNOWN DIAMOND study group
Nov 7, 2017·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Kenji WatanabeUNKNOWN DIAMOND study group
Nov 23, 2017·Alimentary Pharmacology & Therapeutics·H YuK T Park
Feb 13, 2018·Journal of Gastroenterology·Katsuyoshi MatsuokaTooru Shimosegawa
Nov 6, 2018·BMC Gastroenterology·Jörg MahlichRosarin Sruamsiri

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Citations

Feb 2, 2021·Yakugaku zasshi : Journal of the Pharmaceutical Society of Japan·Shinobu Imai
May 21, 2021·Journal of Digestive Diseases·Xiao Xuan LinRen Mao

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Methods Mentioned

BETA
surgical resections
surgical resection

Software Mentioned

SAS
TREAT Resource Evaluation and Assessment Tool

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