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Journal of Crohn's & colitis · 2026

Ustekinumab for ileal stricturing Crohn's disease-an international multicenter retrospective cohort study.

СтатьяМногоцентровое исследованиеНаблюдательное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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El Ouali Sara, Baker Mark E, Lu Cathy, Medellin Alexandra, Bruining David H, Fletcher Joel G, Inoue Aki, Regueiro Miguel, Ottichilo Ronald K, Schoenoff Shayla, Rosentreter Ryan, Bena James, Qazi Taha, Sleiman Joseph, Holubar Stefan D, Gauriloff Samantha, Gandhi Namita S, Cohen Benjamin L, Goren Idan, Balci Numan, Rieder Florian, Stenosis Therapy and Anti-Fibrotic Research (STAR) Consortium

Аннотация

BACKGROUND & AIMS: Stricturing Crohn's disease (CD) is a significant problem, and no selective anti-fibrotic therapies are available. Anti-inflammatory approaches are the mainstay of medical treatment. However, data on the efficacy of ustekinumab (USTE) in ileal stricturing CD are lacking. Our aim was to assess its efficacy in this setting.

METHODS: We performed an international multicenter observational cohort study evaluating adult CD patients who received USTE within 6 months of imaging-confirmed symptomatic stricturing small bowel disease. Outcomes were rates of endoscopic balloon dilation (EBD), surgery, intervention (defined as the composite need for EBD or surgery), recurrent obstructive symptoms, and USTE persistence.

RESULTS: Fifty-seven patients were included (51% female, median age 43 years). Median follow-up was 17 months. Intervention rates were 35%, 45%, and 69% of patients, at 12, 24, and 48 months, respectively. USTE persistence was 78%, 76%, and 52% at 12, 24, and 48 months. Estimated obstructive symptoms rates were 31% and 49% at 12 and 24 months, respectively. EBD within 6 months prior to starting USTE was associated with an increased risk of intervention. Increased bowel wall thickness on imaging, prior biologic use, and obstructive symptom duration were associated with USTE discontinuation. Occurrence of obstructive symptoms during treatment was associated with prior biologic use, EBD within 6 months of starting USTE, and a lower BMI.

CONCLUSIONS: USTE appears to be an appropriate medical option in biologic-experienced CD patients with ileal strictures. Further prospective data are needed to better define outcomes and predictors of response in this setting.

Предметные рубрики MeSH

ИП Урсолов Владлен Сергеевич

ИНН 500118482352 · ОГРНИП 314500117700049

Реквизиты и контакты