Anti-TNF-alpha treatments and obstructive symptoms in Crohn's disease: a prospective study

Dig Liver Dis. 2013 Mar;45(3):258-62. doi: 10.1016/j.dld.2012.10.009. Epub 2012 Nov 26.

Abstract

Background: The development of symptomatic strictures in Crohn's Disease after anti-Tumour Necrosis Factor-α antibodies is undefined.

Aim: To assess, in a prospective longitudinal study, the frequency of sub/obstructions in Crohn's Disease patients after treatment with Infliximab or Adalimumab. Changes of small bowel lesions after these biological therapies were searched by ultrasonography.

Materials and methods: From January 2007 to October 2008, 36 Crohn's Disease patients with no previous sub/obstructions were treated with either Infliximab (n=13) or Adalimumab (n=23) for ≥12months (mean follow-up duration after the first treatment 23.2±6.8months). Small Intestine Contrast Ultrasonography was performed before and after treatment in 19/36 patients. Sonographic parameters included: bowel wall thickness, lumen diameter, bowel dilation and lesion extent.

Results: Sub/obstructions developed in 3/36 patients treated with Infliximab (n=1) or Adalimumab (n=2), all with fibrostricturing Crohn's Disease. Sonographic parameters did not significantly change after treatment.

Conclusions: Sub/obstructive symptoms may develop in one tenth of Crohn's Disease patients treated with anti-Tumour Necrosis Factor-α antibodies, with no significant sonographic changes of the small bowel lesions.

Publication types

  • Clinical Trial

MeSH terms

  • Adalimumab
  • Adult
  • Anti-Inflammatory Agents / therapeutic use*
  • Antibodies, Monoclonal / therapeutic use*
  • Antibodies, Monoclonal, Humanized / therapeutic use*
  • Constriction, Pathologic / diagnostic imaging
  • Constriction, Pathologic / etiology
  • Crohn Disease / diagnostic imaging
  • Crohn Disease / drug therapy*
  • Female
  • Humans
  • Infliximab
  • Intestinal Obstruction / diagnostic imaging
  • Intestinal Obstruction / etiology*
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Prospective Studies
  • Treatment Outcome
  • Tumor Necrosis Factor-alpha / antagonists & inhibitors*
  • Ultrasonography
  • Young Adult

Substances

  • Anti-Inflammatory Agents
  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Humanized
  • Tumor Necrosis Factor-alpha
  • Infliximab
  • Adalimumab