Medical 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.
Dr Anthony Buisson and colleagues assessed efficacy and predictors of therapeutic failure in patients receiving medical treatments for stricturing Crohn’s disease.
The team performed a retrospective study, defining therapeutic failure 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 short-term clinical response rate was 66%|
|Digestive Diseases & Sciences|
The 55 cross-sectional imaging examinations before starting medical therapy were analyzed independently by 2 radiologists.
Among 84 patients, the researchers noted that the therapeutic failure rate within 60 months was 67%.
The research team observed that Crohn’s disease diagnosis after 40 years old, small stricture luminal diameter, increased stricture wall thickness, and fistula with abscess were associated with therapeutic failure, while anti-TNF combotherapy prevented it.
Considering 108 therapeutic sequences, the team found that the short-term clinical response rate was 66%.
The researchers found that male gender, fistula with abscess, and comb sign were associated with short-term clinical failure.
Dr Buisson's team concluded, "Anti-TNF combotherapy seemed to prevent therapeutic failure, and cross-sectional imaging should be systematically performed to help medical management in stricturing Crohn’s disease."